<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03831958</url>
  </required_header>
  <id_info>
    <org_study_id>190051</org_study_id>
    <secondary_id>19-CH-0051</secondary_id>
    <nct_id>NCT03831958</nct_id>
  </id_info>
  <brief_title>Long-Term Follow-Up of Survivors of Pediatric Cushing Disease</brief_title>
  <official_title>Long-Term Follow-UP of Survivors of Pediatric Cushing Disease</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)</agency>
      <agency_class>NIH</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>National Institutes of Health Clinical Center (CC)</source>
  <oversight_info>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Background:&#xD;
&#xD;
      The pituitary gland produces hormones. A tumor in this gland can cause it to produce too much&#xD;
      of the hormone cortisol. Too much cortisol in the body causes Cushing disease. This disease&#xD;
      causes many problems. Some of these problems might persist after the disease is cured.&#xD;
&#xD;
      Objective:&#xD;
&#xD;
      To find out the long-term effects of exposure to high levels of cortisol during childhood and&#xD;
      adolescence.&#xD;
&#xD;
      Eligibility:&#xD;
&#xD;
      People ages 10-42years who were diagnosed with Cushing disease before age 21 and are now&#xD;
      cured and have normal or low cortisol levels&#xD;
&#xD;
      People related to someone with Cushing disease&#xD;
&#xD;
      Design:&#xD;
&#xD;
      Participants will be screened with a medical history.&#xD;
&#xD;
      Participants will complete an online survey. This will include questions about their or their&#xD;
      child s physical and mental health.&#xD;
&#xD;
      All participants will be seen at 5 -year intervals after cure of Cushing disease (5yr, 10yr,&#xD;
      15yr, 20yr (last visit))&#xD;
&#xD;
      Participants who have a relative with Cushing disease will have a medical history and blood&#xD;
      tests or cheek swabs.&#xD;
&#xD;
      Participants who have the disease will have:&#xD;
&#xD;
      Physical exam&#xD;
&#xD;
      Blood tests&#xD;
&#xD;
      Cheek swab&#xD;
&#xD;
      DXA scan: A machine will x-ray the participant s body to measure bone mineral content.&#xD;
&#xD;
      For participants who are still growing, a hand x-ray&#xD;
&#xD;
      Participants with the disease may also have:&#xD;
&#xD;
      Hormone stimulation test: Participants will get a hormone or another substance that will be&#xD;
      measured.&#xD;
&#xD;
      Serial hormone sampling: Participants blood will be measured several times through a thin&#xD;
      plastic tube in an arm vein.&#xD;
&#xD;
      Urine tests: Participants urine may be collected over 24 hours.&#xD;
&#xD;
      MRI: Participants may have a dye injected into a vein. They will lie on a table that slides&#xD;
      into a machine. The machine will take pictures of the body.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Objective:&#xD;
&#xD;
      Cushing Disease (CD) describes the state of hypercortisolemia secondary to cortisol producing&#xD;
      pituitary adenomas. The rarity of the disease (2-5 new cases per million, 1 out of 10 in&#xD;
      children) and the subtle initial findings result in prolonged undiagnosed hypercortisolemia,&#xD;
      that increases the risk for significant complications, including obesity, height&#xD;
      deceleration, hyperlipidemia, hyperglycemia, hypertension, osteoporosis, immunodeficiency,&#xD;
      and others. Although hypercortisolemia usually resolves after successful resection of the&#xD;
      pituitary adenoma, the reversal of the abovementioned complications and the long-term effects&#xD;
      of the previous prolonged exposure of the body to supraphysiologic levels of cortisol have&#xD;
      not been clarified, especially when hypercortisolemia occurs during childhood.&#xD;
&#xD;
      Previous studies have addressed the possible complications after resolution of&#xD;
      hypercortisolemia, but most of them refer to adult patients. Amongst the described&#xD;
      complications, suppression of the pituitary hormones, such as the growth and thyroid hormone&#xD;
      axes, and persistent increase of the body mass index (BMI) and abnormal fat distribution,&#xD;
      have been described in limited number of pediatric patients followed for a few years after&#xD;
      cure. Other complications, such as components of the metabolic syndrome or cardiovascular&#xD;
      dysfunction, have not been extensively studied in children. Furthermore, equally important&#xD;
      are the long-term effects of glucocorticoids on other aspects of health. For example, it has&#xD;
      been previously described that the neurocognitive function of children with CD declines the&#xD;
      first year after treatment. This can potentially result in impaired quality of life, lower&#xD;
      education level, and lower job and life satisfaction in the future; however, the long-term&#xD;
      neurocognitive sequelae of Cushing syndrome (CS) diagnosed in childhood have not been&#xD;
      studied.&#xD;
&#xD;
      This study aims to provide novel insight on the long-term effects of hypercortisolemia on the&#xD;
      developing child, their underlying pathogenetic mechanisms, their evolution over time, and&#xD;
      the risk factors for developing them. This will assist in designing methods to closely&#xD;
      monitor or prevent them in the future. Certain results of this study could potentially apply&#xD;
      to children with iatrogenic CS, which is much more common due to the widespread use of&#xD;
      pharmacologic doses of glucocorticoids in malignancies, autoimmune and atopic disorders.&#xD;
&#xD;
      Study population:&#xD;
&#xD;
      The study population will consist of patients that were previously successfully treated for&#xD;
      CD before the age of 21 years. We aim to identify these patients through review of our&#xD;
      current protocol 97-CH-0076 on &quot;Clinical and genetic investigation of pituitary and&#xD;
      hypothalamic tumors&quot;, which has been recruiting patients since 1997. We will also accept&#xD;
      patients who have been diagnosed and successfully treated for pediatric CD at outside&#xD;
      institutions after reviewing the medical records and confirming their diagnosis. The patients&#xD;
      must not be hypercortisolemic at the time of their recruitment. Family members (any age) of&#xD;
      patients with a family history of pituitary tumors and who will agree to participate in the&#xD;
      DNA/linkage analysis study.&#xD;
&#xD;
      Design:&#xD;
&#xD;
      We will evaluate patients at specific intervals after cure at 5 (+/-1), 10 (+/-1), 15 (+/-1)&#xD;
      and 20 (+/-1) years after documented resolution of hypercortisolemia.&#xD;
&#xD;
      The study will include an online survey offered to all patients, as well as an on-site short&#xD;
      visit for those willing to travel to NIH.&#xD;
&#xD;
      The online survey will include questionnaires on assessment of various aspects of health:&#xD;
      Current medical diagnoses, Medication use, History of endocrine disorders, Fertility, Quality&#xD;
      of life, Behavioral and emotional symptomology, and Socioeconomic and Demographic&#xD;
      information. The survey will be developed and distributed with the help of CTDB and will be&#xD;
      sent with secure email to all the patients and/or their parents (for patients who are &lt;18yo&#xD;
      at the time of evaluation) after consent and eligibility have been confirmed.&#xD;
&#xD;
      The short on-site visit at NIH will be offered to all the patients willing to travel. Blood&#xD;
      tests, imaging studies (MRI pituitary/brain, DXA scan), and neurocognitive screening and&#xD;
      patient reported outcome questionnaires will be performed.&#xD;
&#xD;
      Outcome measures:&#xD;
&#xD;
      The primary outcome measure of the study is the difference of the Body Mass Index (BMI)&#xD;
      z-score of the patients previously treated for pediatric CD compared to the general&#xD;
      population, as calculated by data derived from the NHANES study.&#xD;
&#xD;
      The secondary outcomes will be to describe the prevalence of other endocrine and&#xD;
      non-endocrine abnormalities after successful treatment of CD in childhood, including: growth&#xD;
      hormone, thyroid, gonadal, adrenal function; bone mineral density; glucose metabolism; lipid&#xD;
      profile; cardiovascular abnormalities; immunologic changes; coagulation function; psychiatric&#xD;
      diseases, behavioral symptomology; neurocognitive function; and quality of life.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">March 4, 2019</start_date>
  <completion_date type="Anticipated">January 3, 2040</completion_date>
  <primary_completion_date type="Anticipated">January 3, 2040</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Difference in body mass index z-score of subjects previously treated for Cushing disease compared to general population</measure>
    <time_frame>baseline, 5, 10, 15, 20 years</time_frame>
    <description>The primary outcome measure of the study is the difference in the Body Mass Index (BMI) z-score of the patients previously treated for pediatric CD compared to the general population, as calculated by data derived from the NHANES study.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Prevalence of endocrine and non-endocrine abnormalities</measure>
    <time_frame>baseline, 5, 10, 15, 20 years</time_frame>
    <description>The secondary outcomes will be to describe the prevalence of other endocrine and non-endocrine abnormalities after successful treatment of CD in childhood, including: growth hormone, thyroid, gonadal, adrenal function; bone mineral density; glucose metabolism; lipid profile; cardiovascular abnormalities; immunologic changes; coagulation function; psychiatric diseases, behavioral symptomology; neurocognitive function; and quality of life.</description>
  </secondary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Anticipated">600</enrollment>
  <condition>Cushing Disease</condition>
  <arm_group>
    <arm_group_label>Family member</arm_group_label>
    <description>Family member of survivor of pediatric Cushing disease</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Subjects</arm_group_label>
    <description>survivor of pediatric Cushing disease</description>
  </arm_group>
  <eligibility>
    <study_pop>
      <textblock>
        The study population will consist of patients that were previously successfully treated for&#xD;
        CD before the age of 21 years. We aim to identify these patients through review of our&#xD;
        current protocol 97-CH-0076 on Clinical and genetic investigation of pituitary and&#xD;
        hypothalamic tumors , which has been recruiting patients since 1997. We will also accept&#xD;
        patients who have been diagnosed and successfully treated for pediatric CD at outside&#xD;
        institutions after reviewing the medical records and confirming their diagnosis. The&#xD;
        patients must be normocortisolemic at the time of their recruitment. Family members of&#xD;
        subjects who are survivors of pediatric Cushing disease will be invited to participate in&#xD;
        the DNA/linkage analysis study.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        -  INCLUSION CRITERIA:&#xD;
&#xD;
               1. Males and females 10-42 years old (subjects) who were previously diagnosed and&#xD;
                  had successful treatment of CD before the age of 21 years old. Patients who have&#xD;
                  undergone therapies other than surgical resection (such as radiation or medical&#xD;
                  treatment) will be eligible to participate.&#xD;
&#xD;
               2. Normocortisolemia or hypocortisolemia at the time of the study (as documented&#xD;
                  within past 6 months of recruitment) documented as urine free cortisol or&#xD;
                  midnight/afternoon serum or salivary cortisol levels within or below the normal&#xD;
                  range or documented panhypopituitarism (on glucocorticoid replacement).&#xD;
&#xD;
               3. Patients or a legal guardian (in case of cognitively impaired adults or children)&#xD;
                  must provide assent/consent at the time of the recruitment.&#xD;
&#xD;
               4. Family members (2- 90 yrs.) of patients with a family history of pituitary tumors&#xD;
                  and who agree to participate in the DNA/linkage analysis study.&#xD;
&#xD;
        EXCLUSION CRITERIA:&#xD;
&#xD;
          1. Pregnancy&#xD;
&#xD;
          2. Patients with any medical, physical, psychiatric, or social conditions, which, in the&#xD;
             opinion of the investigators, would make participation in this protocol not in their&#xD;
             best interest, will be excluded from the on-site visit of the study. Patients who are&#xD;
             critically ill, unstable, or with severe organ failure that may affect/limit the&#xD;
             endocrine evaluation and place unsustainable demands on Clinical Center or NICHD&#xD;
             resources will be excluded. They will still be offered the opportunity to participate&#xD;
             in the online questionnaire part of the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>2 Years</minimum_age>
    <maximum_age>90 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Margaret F Keil, C.R.N.P.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Margaret F Keil, C.R.N.P.</last_name>
    <phone>(301) 435-3391</phone>
    <email>keilm@mail.nih.gov</email>
  </overall_contact>
  <location>
    <facility>
      <name>National Institutes of Health Clinical Center</name>
      <address>
        <city>Bethesda</city>
        <state>Maryland</state>
        <zip>20892</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)</last_name>
      <phone>800-411-1222</phone>
      <phone_ext>TTY8664111010</phone_ext>
      <email>prpl@cc.nih.gov</email>
    </contact>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <link>
    <url>https://clinicalstudies.info.nih.gov/cgi/detail.cgi?A_2019-CH-0051.html</url>
    <description>NIH Clinical Center Detailed Web Page</description>
  </link>
  <reference>
    <citation>Stratakis CA. Diagnosis and Clinical Genetics of Cushing Syndrome in Pediatrics. Endocrinol Metab Clin North Am. 2016 Jun;45(2):311-28. doi: 10.1016/j.ecl.2016.01.006.</citation>
    <PMID>27241967</PMID>
  </reference>
  <reference>
    <citation>Davies JH, Storr HL, Davies K, Monson JP, Besser GM, Afshar F, Plowman PN, Grossman AB, Savage MO. Final adult height and body mass index after cure of paediatric Cushing's disease. Clin Endocrinol (Oxf). 2005 Apr;62(4):466-72. doi: 10.1111/j.1365-2265.2005.02244.x.</citation>
    <PMID>15807878</PMID>
  </reference>
  <reference>
    <citation>Keil MF, Graf J, Gokarn N, Stratakis CA. Anthropometric measures and fasting insulin levels in children before and after cure of Cushing syndrome. Clin Nutr. 2012 Jun;31(3):359-63. doi: 10.1016/j.clnu.2011.11.007. Epub 2011 Dec 7.</citation>
    <PMID>22154461</PMID>
  </reference>
  <verification_date>June 28, 2023</verification_date>
  <study_first_submitted>February 5, 2019</study_first_submitted>
  <study_first_submitted_qc>February 5, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 6, 2019</study_first_posted>
  <last_update_submitted>August 1, 2023</last_update_submitted>
  <last_update_submitted_qc>August 1, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">August 2, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Body Mass Index Z Score</keyword>
  <keyword>Adult Height</keyword>
  <keyword>Endocrine Function</keyword>
  <keyword>Neuropsychological Outcome</keyword>
  <keyword>Metabolic Syndrome</keyword>
  <keyword>Natural History</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>ACTH-Secreting Pituitary Adenoma</mesh_term>
    <mesh_term>Pituitary ACTH Hypersecretion</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03831958
org study id: 190051
secondary id: 19-CH-0051
nct id: NCT03831958
lead sponsor: 
is fda regulated drug: No
is fda regulated device: No
Background:

      The pituitary gland produces hormones. A tumor in this gland can cause it to produce too much
      of the hormone cortisol. Too much cortisol in the body causes Cushing disease. This disease
      causes many problems. Some of these problems might persist after the disease is cured.

      Objective:

      To find out the long-term effects of exposure to high levels of cortisol during childhood and
      adolescence.

      Eligibility:

      People ages 10-42years who were diagnosed with Cushing disease before age 21 and are now
      cured and have normal or low cortisol levels

      People related to someone with Cushing disease

      Design:

      Participants will be screened with a medical history.

      Participants will complete an online survey. This will include questions about their or their
      child s physical and mental health.

      All participants will be seen at 5 -year intervals after cure of Cushing disease (5yr, 10yr,
      15yr, 20yr (last visit))

      Participants who have a relative with Cushing disease will have a medical history and blood
      tests or cheek swabs.

      Participants who have the disease will have:

      Physical exam

      Blood tests

      Cheek swab

      DXA scan: A machine will x-ray the participant s body to measure bone mineral content.

      For participants who are still growing, a hand x-ray

      Participants with the disease may also have:

      Hormone stimulation test: Participants will get a hormone or another substance that will be
      measured.

      Serial hormone sampling: Participants blood will be measured several times through a thin
      plastic tube in an arm vein.

      Urine tests: Participants urine may be collected over 24 hours.

      MRI: Participants may have a dye injected into a vein. They will lie on a table that slides
      into a machine. The machine will take pictures of the body.
Objective:

      Cushing Disease (CD) describes the state of hypercortisolemia secondary to cortisol producing
      pituitary adenomas. The rarity of the disease (2-5 new cases per million, 1 out of 10 in
      children) and the subtle initial findings result in prolonged undiagnosed hypercortisolemia,
      that increases the risk for significant complications, including obesity, height
      deceleration, hyperlipidemia, hyperglycemia, hypertension, osteoporosis, immunodeficiency,
      and others. Although hypercortisolemia usually resolves after successful resection of the
      pituitary adenoma, the reversal of the abovementioned complications and the long-term effects
      of the previous prolonged exposure of the body to supraphysiologic levels of cortisol have
      not been clarified, especially when hypercortisolemia occurs during childhood.

      Previous studies have addressed the possible complications after resolution of
      hypercortisolemia, but most of them refer to adult patients. Amongst the described
      complications, suppression of the pituitary hormones, such as the growth and thyroid hormone
      axes, and persistent increase of the body mass index (BMI) and abnormal fat distribution,
      have been described in limited number of pediatric patients followed for a few years after
      cure. Other complications, such as components of the metabolic syndrome or cardiovascular
      dysfunction, have not been extensively studied in children. Furthermore, equally important
      are the long-term effects of glucocorticoids on other aspects of health. For example, it has
      been previously described that the neurocognitive function of children with CD declines the
      first year after treatment. This can potentially result in impaired quality of life, lower
      education level, and lower job and life satisfaction in the future; however, the long-term
      neurocognitive sequelae of Cushing syndrome (CS) diagnosed in childhood have not been
      studied.

      This study aims to provide novel insight on the long-term effects of hypercortisolemia on the
      developing child, their underlying pathogenetic mechanisms, their evolution over time, and
      the risk factors for developing them. This will assist in designing methods to closely
      monitor or prevent them in the future. Certain results of this study could potentially apply
      to children with iatrogenic CS, which is much more common due to the widespread use of
      pharmacologic doses of glucocorticoids in malignancies, autoimmune and atopic disorders.

      Study population:

      The study population will consist of patients that were previously successfully treated for
      CD before the age of 21 years. We aim to identify these patients through review of our
      current protocol 97-CH-0076 on "Clinical and genetic investigation of pituitary and
      hypothalamic tumors", which has been recruiting patients since 1997. We will also accept
      patients who have been diagnosed and successfully treated for pediatric CD at outside
      institutions after reviewing the medical records and confirming their diagnosis. The patients
      must not be hypercortisolemic at the time of their recruitment. Family members (any age) of
      patients with a family history of pituitary tumors and who will agree to participate in the
      DNA/linkage analysis study.

      Design:

      We will evaluate patients at specific intervals after cure at 5 (+/-1), 10 (+/-1), 15 (+/-1)
      and 20 (+/-1) years after documented resolution of hypercortisolemia.

      The study will include an online survey offered to all patients, as well as an on-site short
      visit for those willing to travel to NIH.

      The online survey will include questionnaires on assessment of various aspects of health:
      Current medical diagnoses, Medication use, History of endocrine disorders, Fertility, Quality
      of life, Behavioral and emotional symptomology, and Socioeconomic and Demographic
      information. The survey will be developed and distributed with the help of CTDB and will be
      sent with secure email to all the patients and/or their parents (for patients who are <18yo
      at the time of evaluation) after consent and eligibility have been confirmed.

      The short on-site visit at NIH will be offered to all the patients willing to travel. Blood
      tests, imaging studies (MRI pituitary/brain, DXA scan), and neurocognitive screening and
      patient reported outcome questionnaires will be performed.

      Outcome measures:

      The primary outcome measure of the study is the difference of the Body Mass Index (BMI)
      z-score of the patients previously treated for pediatric CD compared to the general
      population, as calculated by data derived from the NHANES study.

      The secondary outcomes will be to describe the prevalence of other endocrine and
      non-endocrine abnormalities after successful treatment of CD in childhood, including: growth
      hormone, thyroid, gonadal, adrenal function; bone mineral density; glucose metabolism; lipid
      profile; cardiovascular abnormalities; immunologic changes; coagulation function; psychiatric
      diseases, behavioral symptomology; neurocognitive function; and quality of life.
observational model: Cohort
time perspective: Prospective
measure: Difference in body mass index z-score of subjects previously treated for Cushing disease compared to general population
time frame: baseline, 5, 10, 15, 20 years
description: The primary outcome measure of the study is the difference in the Body Mass Index (BMI) z-score of the patients previously treated for pediatric CD compared to the general population, as calculated by data derived from the NHANES study.
measure: Prevalence of endocrine and non-endocrine abnormalities
time frame: baseline, 5, 10, 15, 20 years
description: The secondary outcomes will be to describe the prevalence of other endocrine and non-endocrine abnormalities after successful treatment of CD in childhood, including: growth hormone, thyroid, gonadal, adrenal function; bone mineral density; glucose metabolism; lipid profile; cardiovascular abnormalities; immunologic changes; coagulation function; psychiatric diseases, behavioral symptomology; neurocognitive function; and quality of life.
arm group label: Family member
description: Family member of survivor of pediatric Cushing disease
arm group label: Subjects
description: survivor of pediatric Cushing disease
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 2 Years
maximum age: 90 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Margaret F Keil, C.R.N.P.
role: Principal Investigator
affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
last name: Margaret F Keil, C.R.N.P.
phone: (301) 435-3391
email: keilm@mail.nih.gov
facility: 
status: Recruiting
contact: 
country: United States
url: https://clinicalstudies.info.nih.gov/cgi/detail.cgi?A_2019-CH-0051.html
description: NIH Clinical Center Detailed Web Page
citation: Stratakis CA. Diagnosis and Clinical Genetics of Cushing Syndrome in Pediatrics. Endocrinol Metab Clin North Am. 2016 Jun;45(2):311-28. doi: 10.1016/j.ecl.2016.01.006.
PMID: 27241967
citation: Davies JH, Storr HL, Davies K, Monson JP, Besser GM, Afshar F, Plowman PN, Grossman AB, Savage MO. Final adult height and body mass index after cure of paediatric Cushing's disease. Clin Endocrinol (Oxf). 2005 Apr;62(4):466-72. doi: 10.1111/j.1365-2265.2005.02244.x.
PMID: 15807878
citation: Keil MF, Graf J, Gokarn N, Stratakis CA. Anthropometric measures and fasting insulin levels in children before and after cure of Cushing syndrome. Clin Nutr. 2012 Jun;31(3):359-63. doi: 10.1016/j.clnu.2011.11.007. Epub 2011 Dec 7.
PMID: 22154461
responsible party type: Sponsor
mesh term: ACTH-Secreting Pituitary Adenoma
mesh term: Pituitary ACTH Hypersecretion