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Published: 2025-10-03
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Issue
Vol. 18 No. 3 (2025)
Section
Research

CLINICAL EPIDEMIOLOGICAL CHARACTERISTICS AND RISK FACTORS FOR GLUCOCORTICOID-INDUCED CUSHING SYNDROME IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME

Khac Tung Duong Phan1, 1, Ngoc Sang Nguyen1
1 Hai Phong University of Medicine and Pharmacy

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Abstract

Objective: To describe the clinical epidemiological characteristics and risk factors of glucocorticoid-induced Cushing syndrome in children with idiopathic nephrotic syndrome.


Subjects: 98 pediatric patients with idiopathic nephrotic syndrome treated at Hai Phong Children's Hospital from August 1, 2023 to July 31, 2024.


Methods: Cross-sectional descriptive study.


Results: The prevalence of Cushing syndrome was 41/98 (41.84%), with a male-to-female ratio of 3.6:1. Regarding clinical features, 41/41 (100%) had a round face, 40/41 (97.56%) had central obesity, 37/41 (90.24%) had weight gain, 35/41 (85.37%) had hirsutism, 35/41 (85.37%) had peptic ulcer disease, 20/41 (48.78%) had infections and 3/41 (7.32%) had acute adrenal insufficiency. Regarding investigations, the percentage of decreased ACTH and serum cortisol were 28/41 (68.29%) and 25/41 (60.98%), respectively, while total cholesterol increased in 35/41 (85.37%). Glucocorticoid use ≥ 24 months and non-compliance with treatment increased the risk of Cushing syndrome by 2.3 times and 4.94 times, respectively, in children with idiopathic nephrotic syndrome.


Conclusion: The prevalence of Cushing syndrome was quite high at 41.84%, and it was more common in boys. Most patients had decreased ACTH and serum cortisol levels measured at 8 am. Prolonged glucocorticoid use and non-compliance with treatment increased the risk of Cushing syndrome.

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Keywords

Cushing syndrome, idiopathic nephrotic syndrome, children, glucocorticoid

References

1. Rovin BH, Adler SG, Barratt J et al. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney International 2021;100(4):S140–S160. https://doi.org/10.1016/j.kint.2021.05.021
2. Phạm Thị Hương, Nguyễn Ngọc Sáng. Đặc điểm dịch tễ học lâm sàng và đáp ứng với điều trị bằng prednisolon trong hội chứng thận hư tiên phát tại Bệnh viện Nhi Thái Bình. Tạp chí Y học Việt Nam 2023;Số chuyên đề:160–166.
3. Nguyễn Thị Linh. Nhận xét đặc điểm lâm sàng, cận lâm sàng hội chứng Cushing do thuốc trên bệnh nhân hội chứng thận hư tiên phát kháng corticosteroid tại bệnh viện Nhi Trung ương, Luận văn Thạc sĩ Y học, Trường Đại học Y Hà Nội, Hà Nội, 2019.
4. Carroll TB, Aron DC. Glucocorticoids and Adrenal Androgens. Greenspan’s Basic and Clinical Endocrinology. 10th, McGraw-Hill Education, 2017:299–343.
5. Hahn D, Samuel SM, Willis NS et al. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev 2020;(8):CD001533. https://doi.org/10.1002/14651858.cd001533.pub6
6. Bế Hà Thành. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và một số yếu tố liên quan gây ra hội chứng Cushing do thuốc, Luận văn Thạc sĩ Y học, Đại học Y Hà Nội, Hà Nội, 2018.
7. Verónica Araya A, Liberman C, Munizaga C et al. Combination of High Prevalence Sign/Symptom Pairs: An Approach to the Diagnosis of Cushing’s Syndrome. Adrenal Glands - The Current Stage and New Perspectives of Diseases and Treatment [Working Title]. IntechOpen, 2022.
8. Delfs N, Struja T, Gafner S et al. Outcomes of Hospitalized Patients with Glucocorticoid-Induced Hyperglycemia - A Retrospective Analysis. Journal of Clinical Medicine 2020;9(12):4079. https://doi.org/10.3390/jcm9124079