{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T20:18:23Z","timestamp":1658866703699},"reference-count":0,"publisher":"Walter de Gruyter GmbH","issue":"11-12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>\n                  <jats:bold>Background:<\/jats:bold> Cushing\u2019s disease is very rare in children, and the diagnosis is frequently delayed by several years.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Objective:<\/jats:bold> We report a case of prepubertal Cushing\u2019s disease with a medical history of only 9 months. This case illustrates the difficulties involved in diagnosing children at the early stage of the disease.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Case presentation:<\/jats:bold> An 8-year-old prepubertal boy presented with rapid weight gain accompanied by a decreasing growth velocity and hirsutism. Thyroid function tests and growth factor levels were normal, thus excluding hypothyroidism and growth hormone deficiency. Cushing\u2019s syndrome was confirmed by elevated 24-h urinary free cortisol levels, increased diurnal cortisol levels, and a lack of cortisol suppression in the low-dose dexamethasone suppression test. Further tests to investigate the source of the hypercortisolism showed the following results: Basal morning adrenocorticotropic hormone (ACTH) was normal. The high-dose dexamethasone suppression test led to a 51% decrease in cortisol level. In the corticotropin-releasing hormone (CRH) test, ACTH and cortisol increased only by 28%. Repeated magnetic resonance imaging (MRI) finally revealed a microadenoma in the anterior pituitary, thus establishng the diagnosis of Cushing\u2019s disease. Upon diagnosis, the patient underwent transsphenoidal surgery. Histological analysis confirmed an ACTH-secreting pituitary adenoma.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion:<\/jats:bold> This case illustrates the difficulties associated with the clinical, biochemical, and radiological diagnoses of Cushing\u2019s disease in children. Early diagnosis remains a challenge because test results often do not match standard diagnostic criteria.<\/jats:p>","DOI":"10.1515\/jpem-2014-0230","type":"journal-article","created":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T09:04:06Z","timestamp":1614503046000},"page":"1043-1047","source":"Crossref","is-referenced-by-count":3,"title":["How early can one diagnose Cushing\u2019s disease? An early diagnosis in a case of prepubertal Cushing\u2019s disease"],"prefix":"10.1515","volume":"27","author":[{"given":"Julia","family":"Hoppmann","sequence":"first","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel V.","family":"Wagner","sequence":"additional","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gudrun","family":"Junghans","sequence":"additional","affiliation":[{"name":"Paediatric Practice, Querstra\u00dfe 6, 04889 Schildau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan A.","family":"Wudy","sequence":"additional","affiliation":[{"name":"Steroid Research and Mass Spectrometry Unit, Center for Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Buchfelder","sequence":"additional","affiliation":[{"name":"University of Erlangen-N\u00fcrnberg, Department of Neurosurgery, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz W.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Ritter","sequence":"additional","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wieland","family":"Kiess","sequence":"additional","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Pf\u00e4ffle","sequence":"additional","affiliation":[{"name":"University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2014,11,4]]},"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2014-0230\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2014-0230\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T09:04:07Z","timestamp":1614503047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2014-0230\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,1]]},"references-count":0,"journal-issue":{"issue":"11-12","published-online":{"date-parts":[[2014,11,4]]},"published-print":{"date-parts":[[2014,11,1]]}},"alternative-id":["10.1515\/jpem-2014-0230"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2014-0230","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2014,11,1]]}}}