ESPE Abstracts

Introduction: Cushing’s syndrome is rare in the paediatric population, affecting 0.89 per million children between the ages of 0 and 20 years. The causes of Cushing’s syndrome of endogenous origin are dominated by pituitary causes in 70-95%, with a peripubertal revelation. We report the case of a child followed for Cushing’s disease in the department of Endocrinology-Diabetology-Nutrition of Mohammed-VI University Hospital Center of Oujda, in the eastern of Morocco.

Observation: It is a 14-year-old female child, without any particular pathological history, referred to our department for secondary amenorrhea, weight gain and hirsutism. The clinical examination found an obese child with a BMI of 35.5 kg/m², large purple stretch marks and a puffy face. Biological assessment revealed ACTH-dependent biological hypercortisolism. Hypothalamic-pituitary MRI revealed a pituitary microadenoma measuring 4 mm. The case was discussed in a multidisciplinary meeting including endocrinologists, neurosurgeons, radiotherapists, and oncologists, then the patient benefited from a selective microadenectomy with complete post-operative remission.

Discussion-Conclusion: Cushing’s disease in children is a diagnostic and therapeutic emergency. Early diagnosis remains a challenge for the clinician in order to prevent the consequences of hypercortisolism especially on growth and puberty. It requires a rigorous evaluation as well as a codified management as soon as possible, following a multidisciplinary meeting. Transphenoïdal surgery remains the only curative treatment.

Key-words: Cushing’s disease – children