HẬU QUẢ VÀ CÁC YẾU TỐ LIÊN QUAN CỦA HỘI CHỨNG CUSHING THỨ PHÁT Ở TRẺ EM

Abstract

Exogenous Cushing's syndrome is a multisystem disorder caused by long-term use of glucocorticoids. If not detected early, it causes a lot of serious consequences both physically and psychologically for the child. Objective: Describe the consequences and related factors of exogenous Cushing's syndrome in children. Subjects: 194 children with exogenous Cushing's syndrome were diagnosed at Vietnam National Children's Hospital from February 2022 to February 2023. Methods: Description of case series, retrospective and prospective. Results: The male: female ratio was 57.7:42.3 with the median age of diagnosis being 4.5 years old, the youngest being 3 months old and the oldest being 18.2 years old. The median duration of glucocorticoids use was 4 months, with children using the drug for the longest duration up to 12 years. Up to 20.2% of children with height being ≤ -2 SD (WHO) and 66.9% of them were overweight and obese. 82.9% of children had adrenal insufficiency; 36% of them had insulin resistance; 56.4% of children had hyperlipidemia; 12.8% of them had hypocalcemia and 23% of them had vitamin D deficiency. Conclusions: Exogenous Cushing's syndrome in children causes severe metabolic consequences such as insulin resistance, hyperlipidemia, calcium and vitamin D deficiency, delayed physical development with short status but increased BMI. Recommendation: Medical staff need to prescribe glucocorticoids appropriately to avoid the consequences of exogenous Cushing's syndrome in children. On the other hand, it is necessary to recognize early signs of exogenous Cushing's syndrome to make appropriate adjustments in treatment as well as prevent possible complications