Children with Cushing's syndrome: primary pigmented nodular adrenocortical disease should always be suspected

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dc.contributor.authorGoncalves da Silva, Renata Marques [UNIFESP]
dc.contributor.authorPinto, Emilia
dc.contributor.authorGoldman, Suzan M. [UNIFESP]
dc.contributor.authorAndreoni, Cassio [UNIFESP]
dc.contributor.authorVieira, Teresa C. [UNIFESP]
dc.contributor.authorAbucham, Julio [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2016-01-24T14:06:15Z
dc.date.available2016-01-24T14:06:15Z
dc.date.issued2011-03-01
dc.description.abstractPrimary Pigmented Nodular Adrenocortical Disease (PPNAD) is a rare form of bilateral adrenocortical hyperplasia that is inherited in an autosomal dominant manner and leads to ACTH-independent Cushing's syndrome (CS). PPNAD may be isolated or associated with Carney Complex (CNC). for the diagnosis of PPNAD and CNC, in addition to the hormonal and imaging tests, searching for PRKAR1A mutations may be recommended. the aims of the present study are to discuss the clinical and molecular findings of two Brazilian patients with ACTH-independent CS due to PPNAD and to show the diagnostic challenge CS represents in childhood. Description of two patients with CS and the many sequential steps for the diagnosis of PPNAD is provided. Sequencing analysis of all coding exons of PRKAR1A in the blood, frozen adrenal nodules (patients 1 and 2) and testicular tumor (patient 1) is performed. After several clinical and laboratory drawbacks that misled the diagnostic investigation in both patients, the diagnosis of PPNAD was finally established and confirmed through pathology and molecular studies. in patient 1, sequencing of PRKAR1A gene revealed a novel heterozygous 10-bp deletion in exon 3, present in his blood, adrenal gland and testicular tumor. the etiologic diagnosis of endogenous CS in children is a challenge that requires expertise and a multidisciplinary collaboration for its prompt and correct management. Although rare, PPNAD should always be considered among the possible etiologies of CS, due to the high prevalence of this disease in this age group.en
dc.description.affiliationUniversidade Federal de São Paulo, Neuroendocrine Unit, Div Endocrinol, Escola Paulista Med, BR-04039002 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Div Endocrinol & Metab, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Neuroendocrine Unit, Div Endocrinol, Escola Paulista Med, BR-04039002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent61-67
dc.identifierhttp://dx.doi.org/10.1007/s11102-010-0260-5
dc.identifier.citationPituitary. New York: Springer, v. 14, n. 1, p. 61-67, 2011.
dc.identifier.doi10.1007/s11102-010-0260-5
dc.identifier.issn1386-341X
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/33515
dc.identifier.wosWOS:000287453200009
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofPituitary
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0
dc.subjectCushing's syndromeen
dc.subjectPPNADen
dc.subjectCarney complexen
dc.subjectPRKAR1A mutationen
dc.subjectACTH-independent CSen
dc.titleChildren with Cushing's syndrome: primary pigmented nodular adrenocortical disease should always be suspecteden
dc.typeinfo:eu-repo/semantics/article
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