쿠싱 증후군 Cushing syndrome

그림 1-97. 적색 표시 부위가 부신이다.

Copyright ⓒ 2011 John Sangwon Lee, MD., FAAP

쿠싱 증후군의 진단

• 과거 병력, 증상 징후, 진찰소견과 혈중 전해질 농도, CBC 피 검사, 혈중 인슐린 농도, 혈중 코티솔 농도, 소변 코티솔 농도, 혈중 성장 호르몬 농도 등의 임상 검사, 골 X-선 검사, 뇌하수체와 부신 CT 스캔 검사나 MRI 검사 등을 종합해서 진단한다. 

쿠싱 증후군의 감별 진단

• 단순 비만증과 쿠싱 증후군을 감별 진단해야 할 때가 많다. 
• 단순 비만증을 가진 아이의 성장 발육은 정상이든지 동년배들보다 더 빠른 것이 보통이다. 
• 쿠싱 증후군을 가진 아이들은 어딘가 아픈 것 같이 허약해 보이고 
• 쿠싱 증후군으로 생긴 선조는 자주색이고 비만증으로 생긴 선조는 붉은 것이 일반적이다. 

쿠싱 증후군의 치료 

• 뇌하수체 종양, 부신피질 종양, 변위성 종양, 또는 부신 과형성증 등을 수술로 치료 할 수 있다. 
• 필요에 따라 코티솔이나 부신피질 자극 호르몬으로 일생동안 치료한다. 

 

Cushing syndrome 쿠싱 증후군

• Excessive secretion of the hormone Cortisol is caused by benign tumors in the adrenal cortex, malignant tumors in the adrenal cortex, and other tumors.

• with hypertension

• An illness in which multiple symptoms, such as obesity, can appear is called Cushing’s syndrome.

Causes of Cushing’s syndrome

• Adrenal cortical malignancies

• or benign tumors in the adrenal cortex,

• bilateral adrenal hyperplasia,

• pituitary gland tumors,

• Cushing’s syndrome can be caused by displaced tumors that secrete corticosteroids (ACTH).

• Long-term treatment with an overdose corticosteroid may cause symptoms similar to those of Cushing’s syndrome.

• This syndrome can occur at any age, regardless of age, but it is more prevalent in girls under 7 years of age.

Symptoms, signs of Cushing’s syndrome

• Obesity, full moon-shaped  round face, hairy hair, clitoral enlarged, acne, high blood pressure, purple striae, delayed growth and development, facial flushing due to heavy blood, water buffalo hexagonal neck and shoulders, etc. Various symptoms may appear.

Figure 1-97. The red marked area is the adrenal gland. Copyright ⓒ 2011 John Sangwon Lee, MD., FAAP

Diagnosis of Cushing’s Syndrome

• Past medical history, symptom signs, examination findings and blood electrolyte concentration, CBC blood test, blood insulin concentration, blood cortisol concentration, urine cortisol concentration, clinical examination such as blood growth hormone concentration, bone X-ray examination, pituitary gland and adrenal gland CT scan Comprehensive diagnosis such as an examination or MRI examination is performed.

Differential diagnosis of Cushing’s syndrome

• It is often necessary to differentiate between simple obesity and Cushing’s syndrome.

• Children with simple obesity usually develop normal or faster than their peers.

• Children with Cushing’s Syndrome look weak and feel sick somewhere

• The striae resulting from Cushing’s syndrome are purple and the striae resulting from obesity are usually red.

Treatment of Cushing’s syndrome

• Pituitary gland tumors, adrenal cortical tumors, displaced tumors, or adrenal hyperplasia can be treated with surgery.

• Treat lifelong with cortisol or corticosteroids as needed.

출처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy Pediatrics

• www.drle epediatrics.com제14권. 소아청소년 내분비, 유전, 염색체, 대사, 희귀병

• www.drleepediatrics.com제6권 신생아 성장 발육 육아 질병
• www.drleepediatrics.com제7권 소아청소년 감염병
• www.drleepediatrics.com제8권 소아청소년 호흡기 질환
• www.drleepediatrics.com제9권 소아청소년 소화기 질환
• www.drleepediatrics.com제10권. 소아청소년 신장 비뇨 생식기 질환
•  www.drleepediatrics.com제11권. 소아청소년 심장 혈관계 질환
• www.drleepediatrics.com제12권. 소아청소년 신경 정신 질환, 행동 수면 문제
• www.drleepediatrics.com제13권. 소아청소년 혈액, 림프, 종양 질환
•  Red book 29th-31st edition 2021
• Nelson Text Book of Pediatrics 19^{th —} 21st Edition
• The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition

• Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
• Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
• Emergency care, Harvey grant, and Robert Murray
• Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
• Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
• Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
• The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
• Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
• Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
• Manual of Emergency Care
• 응급환자관리 정담미디어
• 소아가정간호백과–부모도 반의사가 되어야 한다, 이상원
• Neonatal Resuscitation American heart Association
• Neonatology Jeffrey J.Pomerance, C. Joan Richardson
• Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
• Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
• Preparation for Birth. Beverly Savage and Dianna Smith
• Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
• The Harriet Lane Handbook 19th Edition
• 소아과학 대한교과서
• 제1권 소아청소년 응급의료 참조문헌과 출처
• Other

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”