Abstract
In this brief report, we review the unique characteristics of Cushing disease (CD) in children, as well as the most important new genetic discoveries associated with childhood CD. We often forget it, but CD refers to Cushing syndrome caused by pituitary corticotroph adenomas only. Thus, here we only refer to the new discoveries associated with pituitary tumors. There is indeed a wealth of new information on clinical features, outcomes, and genetic determinants of CD in children!
Similar content being viewed by others
References
Fleseriu M, Auchus R, Bancos I, Ben-Shlomo A, Bertherat J, Biermasz NR, Boguszewski CL, Bronstein MD, Buchfelder M, Carmichael JD, Casanueva FF, Castinetti F, Chanson P, Findling J, Gadelha M, Geer EB, Giustina A, Grossman A, Gurnell M, Ho K, Ioachimescu AG, Kaiser UB, Karavitaki N, Katznelson L, Kelly DF, Lacroix A, McCormack A, Melmed S, Molitch M, Mortini P, Newell-Price J, Nieman L, Pereira AM, Petersenn S, Pivonello R, Raff H, Reincke M, Salvatori R, Scaroni C, Shimon I, Stratakis CA, Swearingen B, Tabarin A, Takahashi Y, Theodoropoulou M, Tsagarakis S, Valassi E, Varlamov EV, Vila G, Wass J, Webb SM, Zatelli MC, Biller BMK (2021) Consensus on diagnosis and management of cushing’s disease: a guideline update. Lancet Diabetes Endocrinol 9(12):847–875
Tatsi C, Bompou ME, Flippo C, Keil M, Chittiboina P, Stratakis CA (2021) Paediatric patients with cushing disease and negative pituitary MRI have a higher risk of nonremission after transsphenoidal surgery. Clin Endocrinol (Oxf) 95(6):856–886
Valdés N, Tirosh A, Keil M, Stratakis CA, Lodish M (2021) Pediatric cushing’s syndrome: greater risk of being overweight or obese after long-term remission and its predictive factors. Eur J Endocrinol 184(1):179–187
Keil MF, Kang JY, Liu A, Wiggs EA, Merke D, Stratakis CA (2022) Younger age and early puberty are associated with cognitive function decline in children with cushing disease. Clin Endocrinol (Oxf) 96(4):569–577
Keil MF, Stratakis CA (2008) Pituitary tumors in childhood: update of diagnosis, treatment and molecular genetics. Expert Rev Neurother 8:563–574. https://doi.org/10.1586/14737175.8.4.563
Tatsi C, Stratakis CA (2020) Aggressive pituitary tumors in the young and elderly. Rev Endocr Metab Disord 21(2):213–223
Cho HY et al (2010) Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary adenomas. Clin Endocrinol (Oxf) 72:648–653. https://doi.org/10.1111/j.1365-2265.2009.03673.x
Tatsi C, Flippo C, Stratakis CA (2020) Cushing syndrome: old and new genes. Best Pract Res Clin Endocrinol Metab 34(2):101418
Giusti F et al (2017) Multiple endocrine neoplasia syndrome type 1: institution, management, and data analysis of a nationwide multicenter patient database. Endocrine 58:349–359. https://doi.org/10.1007/s12020-017-1234-4
Hernández-Ramírez LCF, Faucz FR, Lodish M, Pankratz N, Chittiboina P, Lane J, Kay D, Mills J, Stratakis CA (2019) Non-syndromic cushing’s disease due to CDKN1B mutations: novel mutations and phenotypic features in a large pediatric cohort. J Endocr Soc. https://doi.org/10.1210/js.2019-OR24-6
Faucz FR et al (2017) Somatic USP8 gene mutations are a common cause of pediatric cushing disease. J Clin Endocrinol Metab 102:2836–2843. https://doi.org/10.1210/jc.2017-00161
Cohen M et al (2019) Germline USP8 mutation associated with pediatric Cushing disease and other clinical features: a new syndrome. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2019-00697
de Kock L et al (2014) Pituitary blastoma: a pathognomonic feature of germ-line DICER1 mutations. Acta Neuropathol 128:111–122. https://doi.org/10.1007/s00401-014-1285-z
Tatsi C, Stratakis CA (2018) Neonatal cushing syndrome: a rare but potentially devastating disease. Clin Perinatol 45:103–118. https://doi.org/10.1016/j.clp.2017.10.002
Tatsi C et al (2019) Large genomic aberrations in corticotropinomas are associated with greater aggressiveness. J Clin Endocrinol Metab 104:1792–1801. https://doi.org/10.1210/jc.2018-02164
Acknowledgements
I want to thank the Cushing’s protocol team at the NIH Warren Magnuson Clinical Center that assisted me there for 26 years (1995–2021). Drs. Keil, Lodish and Tatsi among many others were instrumental in the success of our studies. I also want to express my gratitude to our patients and their families that participated and supported our research. Funding for these studies was provided by the intramural program of NICHD, NIH, Bethesda, MD20892, USA.
Funding
This work was funded in part by the intramural program of NICHD, NIH, Bethesda, MD, USA and the IMBB, FORTH, Heraklion, Crete, Greece, in addition to the ELPEN Research Institute, Athens, Greece.
Author information
Authors and Affiliations
Contributions
Dr. CAS wrote the manuscript and is solely responsible for its content.
Corresponding author
Ethics declarations
Competing interests
The authors declare that they have no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Stratakis, C.A. Cushing’s disease in children: unique features and update on genetics. Pituitary 25, 764–767 (2022). https://doi.org/10.1007/s11102-022-01237-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11102-022-01237-9