Kidney Stones as an Underrecognized Clinical Sign in Pediatric Cushing Disease

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• 作者：Sara H. Rahman ; BA¹ ; ² ; Georgios Z. Papadakis ; MD³ ; Margaret F. Keil ; PhD ; CRNP¹ ; Fabio R. Faucz ; PhD¹ ; Maya B. Lodish ; MD¹ ; ^&lowast ; ; ^{lodishma@mail.nih.gov" class="auth_mail" title="E-mail the corresponding author} ; Constantine A. Stratakis ; MD¹ ; ^&lowast ;
• 关键词：ACTH ; Adrenocorticotrophic hormone ; Ca/Cr ; Calcium/creatinine ; CD ; Cushing disease ; CS ; Cushing syndrome ; CT ; Computed tomography ; MEN1 ; Multiple endocrine neoplasia 1 ; MRI ; Magnetic resonance imaging ; NIH ; National Institutes of Health ; TSS ; Transsphenoidal surgery ; UFC ; Urine free cortisol
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：170
• 期：Complete
• 页码：273-277.e1
• 全文大小：340 K

文摘

To investigate the prevalence of kidney stones in a population of children with Cushing disease (CD) and to compare it with the prevalence of kidney stones in healthy children.

Study design

Clinical and biochemical data from 139 pediatric patients with CD (68 females, 71 males) were analyzed retrospectively. Computed tomography scans were reviewed for kidney stones.

Results

Among 139 patients, 27 with CD (19.4%) had either radiographic evidence and/or a history of kidney stones. Those with kidney stones had higher urine free cortisol (P = .008) and transsphenoidal surgery at an older age (P = .007). The average urinary calcium/creatinine ratio was elevated in patients with CD (0.22 ± 0.11). The prevalence of kidney stones was higher in children with CD than in normal children (19.42% vs 1.0%; P < .001).

Conclusion

Our results illustrate that kidney stones are an underestimated complication of pediatric CD, especially when compared with the prevalence of nephrolithiasis in the general pediatric population. Long-term consequences for kidney function are not known and need to be studied.