{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:43:08Z","timestamp":1772638988528,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Lodz","award":["503\/1-107-03\/503-11-001"],"award-info":[{"award-number":["503\/1-107-03\/503-11-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cushing\u2019s disease (CD) is an extremely rare diagnosis in children. In this report, we present the case of an almost 16-year-old, short and thin boy with CD, the first symptoms of which were spinal pain and vertebral fractures as a result of osteoporosis. In light of his growth retardation and short stature, the boy underwent diagnostics, which excluded growth hormone (GH) deficiency, hypothyroidism and celiac disease. Finally, based on cortisol profile results, dexamethasone suppression tests and bilateral sampling during catheterization of the inferior petrosal sinuses, CD was diagnosed.<\/jats:p>","DOI":"10.3390\/jcm12185967","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T04:06:13Z","timestamp":1694750773000},"page":"5967","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Osteoporosis as the First Sign of Cushing\u2019s Disease in a Thin 16-Year-Old Boy\u2014A Case Report"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-5877","authenticated-orcid":false,"given":"Anna","family":"\u0141upi\u0144ska","sequence":"first","affiliation":[{"name":"Department of Paediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland"},{"name":"Department of Endocrinology and Metabolic Diseases, Polish Mother\u2019s Memorial Hospital\u2014Research Institute, 93-338 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9168-0192","authenticated-orcid":false,"given":"Sara","family":"Aszkie\u0142owicz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Polish Mother\u2019s Memorial Hospital\u2014Research Institute, 93-338 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Zieli\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-2186","authenticated-orcid":false,"given":"Renata","family":"Stawerska","sequence":"additional","affiliation":[{"name":"Department of Paediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland"},{"name":"Department of Endocrinology and Metabolic Diseases, Polish Mother\u2019s Memorial Hospital\u2014Research Institute, 93-338 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8748-3337","authenticated-orcid":false,"given":"Andrzej","family":"Lewi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Polish Mother\u2019s Memorial Hospital\u2014Research Institute, 93-338 Lodz, Poland"},{"name":"Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 93-338 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s11154-021-09626-4","article-title":"Paediatric Cushing\u2019s disease: Epidemiology, pathogenesis, clinical management and outcome","volume":"22","author":"Ferrigno","year":"2021","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.ecl.2012.08.002","article-title":"Cushing syndrome in pediatrics","volume":"41","author":"Stratakis","year":"2012","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.5114\/pedm.2019.87179","article-title":"Cushing disease in children and adolescents\u2014Assessment of the clinical course, diagnostic process, and effects of the treatment\u2014Experience from a single paediatric centre","volume":"25","author":"Hull","year":"2019","journal-title":"Pediatr. Endocrinol. Diabet. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.6065\/apem.2346074.037","article-title":"Cushing disease in pediatrics: An update","volume":"28","author":"Armas","year":"2023","journal-title":"Ann. Pediatr. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"955945","DOI":"10.3389\/fendo.2022.955945","article-title":"Outcome of CRH stimulation test and overnight 8 mg dexamethasone suppression test in 469 patients with ACTH-dependent Cushing\u2019s syndrome","volume":"13","author":"Detomas","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.jpeds.2009.12.027","article-title":"Effects of Cushing disease on bone mineral density in a pediatric population","volume":"56","author":"Lodish","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S2213-8587(16)00086-3","article-title":"Complications of Cushing\u2019s syndrome: State of the art","volume":"4","author":"Pivonello","year":"2016","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1210\/jc.2012-3604","article-title":"Outcome of surgical treatment of 200 children with Cushing\u2019s disease","volume":"98","author":"Lonser","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Detomas, M., Deutschbein, T., Tamburello, M., Chifu, I., Kimpel, O., Sbiera, S., Kroiss, M., Fassnacht, M., and Altieri, B. (J. Endocrinol. Investig., 2023). Erythropoiesis in Cushing syndrome: Sex-related and subtype-specific differences. Results from a monocentric study, J. Endocrinol. Investig., epub ahead of print.","DOI":"10.1007\/s40618-023-02128-x"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1136\/rmdopen-2014-000014","article-title":"Glucocorticoid-induced osteoporosis","volume":"1","author":"Briot","year":"2015","journal-title":"RMD Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"693","DOI":"10.3390\/nu2070693","article-title":"Vitamin D and bone health; potential mechanisms","volume":"2","author":"Laird","year":"2010","journal-title":"Nutrients"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"di Filippo, L., Frara, S., Nannipieri, F., Cotellessa, A., Locatelli, M., Querini, P.R., and Giustina, A. (2023). Low vitamin D levels are associated with long COVID syndrome in COVID-19 survivors. J. Clin. Endocrinol. Metab., 1\u201311.","DOI":"10.1210\/clinem\/dgad207"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1210\/clinem\/dgab599","article-title":"Vitamin D levels are associated with blood glucose and BMI in COVID-19 patients, predicting disease severity","volume":"107","author":"Allora","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.tem.2007.03.005","article-title":"Pediatric Cushing\u2019s syndrome: Epidemiology, investigation and therapeutic advances","volume":"18","author":"Storr","year":"2007","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.11005\/jbm.2012.19.2.153","article-title":"Case of Cushing syndrome diagnosed by recurrent pathologic fractures in a young woman","volume":"19","author":"Han","year":"2012","journal-title":"J. Bone Metab."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Elenius, H., McGlotten, R., and Nieman, L.K. (J. Clin. Endocrinol. Metab, 2023). Ovine CRH stimulation and 8 mg dexamethasone suppression tests in 323 patients with ACTH-dependent Cushing\u2019s syndrome, J. Clin. Endocrinol. Metab, Epub ahead of print.","DOI":"10.1210\/clinem\/dgad454"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing\u2019s syndrome: An Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4103\/2230-8210.104032","article-title":"Pediatric Cushing\u2019s disease: Management issues","volume":"16","author":"Savage","year":"2012","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/ejendo\/lvad050","article-title":"Bilateral inferior petrosal sinus sampling with human CRH stimulation in ACTH-dependent Cushing\u2019s syndrome: Results from a retrospective multicenter study","volume":"188","author":"Detomas","year":"2023","journal-title":"Eur. J. Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1210\/clinem\/dgz194","article-title":"The optimal cut-off of BIPSS in differential diagnosis of ACTH-dependent Cushing\u2019s syndrome: Is stimulation necessary?","volume":"105","author":"Chen","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Eviz, E., Yesiltepe, M.G., Arduc, A.A., Erbey, F., Guran, T., and Hatun, S. (2023). An overlooked manifestation of hypercortisolism\u2014Cerebral cortical atrophy and challenges in identifying the etiology of hypercortisolism: A report of 2 pediatric cases. Horm. Res. Paediatr., 27.","DOI":"10.1159\/000530391"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Paragliola, R.M., Corsello, A., Papi, G., Pontecorvi, A., and Corsello, S.M. (2021). Cushing\u2019s syndrome effects on the thyroid. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22063131"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Pomahacova, R., Paterova, P., Nykodymova, E., Sykora, J., and Krsek, M. (2022). Pediatric Cushing\u2019s disease: Case reports and retrospective review. Biomed. Pap. Med. Fac. Univ. Palacky. Olomouc. Czech Repub., 166.","DOI":"10.5507\/bp.2022.049"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5967\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:50:53Z","timestamp":1760129453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5967"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,14]]},"references-count":23,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12185967"],"URL":"https:\/\/doi.org\/10.3390\/jcm12185967","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,14]]}}}