RT Book, Section
A1 Appachi, Elumalai
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114879387
T1 Cushing Syndrome
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114879387
RD 2022/05/27
AB A  21-month-old  girl  is  brought  to  the  pediatrician  for  a  routine  physical  examination.  The  mother  notes  that  the  child  has  recently  gained  an  excessive  amount  of  weight.  Examination  shows  an  obese  toddler  who  has  a  blood  pressure  of  130/90  mm  Hg.  The  linear  growth  is  noted  to  be  abnormal  and  her  weight  has  jumped  from  the  50th  percentile  at  the  last  visit  6  months  ago  to  above  the  90th  percentile.  The  girl  has  hirsutism  and  acne  on  the  forehead  (Figure  195-1).  Urinalysis  shows  glycosuria.  The  pediatrician  is  suspicious  for  hypercortisolism  and  refers  the  child  to  a  pediatric  endocrinologist.  A  dexamethasone  suppression  test  reveals  lack  of  suppression  of  cortisol,  consistent  with  Cushing  syndrome.  A  CT  scan  of  the  abdomen  reveals  an  adrenal  tumor,  which  is  surgically  resected  and  found  to  be  an  adrenal  adenoma.  The  girl  is  maintained  on  glucocorticoid  therapy  and  recovers.