La maladie de cushing de l'enfant [a propos de 4 cas]

ABSTRACT

Cushing's syndrome is rarely met before the adult age. We report four observations of between 11 and 16 years old. The symtomatology is particular at this age. It's characterized by both faciotruncal obesity and growth slowing down which is always very noticed. The cortisol plasmatique, and mainly a fre urinary cortisol, is really pathologic. The dynamic tests are for the cushing's syndrome. The pituitary scanography shows a microadenoma in 2 cases from 4. For another case, nuclear magnetic resonance imaging was better than scanography. These 4 observations show either the difficulty met in therapeutic responsibility and the recent proposed attitude by first intention, but there is problem of a postoperative growth hormone deficiency which should be compensated. The radiotherapy gives best result compared with adult, it was realized for two patients because their parents didn't admit any surgical intervention. The medical treatment is important for the hypercortisolism control before surgical operation, or waiting for the radiotherapy efficiency. Words keys Cushing's, Cushing disease, children