Cushing's Syndrome: Experience of the Endocrinology Department at University Hospital Center Mohammed VI, Marrakech

Endogenous Cushing's syndrome or endogenous hypercorticism is a rare entity, due to chronic, excessive tissue exposure to glucocorticoids, resulting from excess adrenocorticotropic hormone production or excessive adrenal-autonomous secretion of glucocorticoids. The diagnosis can only be made if the clinical features and biochemical abnormalities are present. Its comorbidities and complications can easily lead to death. Our work is a retrospective descriptive study of all patients with Cushing's syndrome hospitalized in the Endocrinology and Metabolic Diseases Department of the Mohamed VI University Hospital, Marrakech, a total of 34 patients. The aim of this study was to establish the epidemiological, clinical, radiological and etiological profile of Cushing's syndrome observed in the Endocrinology Department of the CHU, and to evaluate the diagnostic modalities, associated parameters and therapeutic management, while comparing them with data in the national and international literature. Our series was characterized by a clear female predominance (4/1) and an average age of 29.2 years. Discovery followed weight gain in 53% of patients, headache in 35%, hirsutism and secondary amenorrhea in 32% and 29% respectively. The most common clinical signs were hypercorticism in 71% of cases and hyperandrogenism in 59%. Biologically, to detect hypercorticism, dexamethasone minute braking was performed in 65% of cases. ACTH dependence was found in 91% of cases, with Cushing's disease found in 53% of cases, diagnosed on MRI, with a microadenoma in 65% of cases. Among the causes of ACTH Independence, adrenocortical carcinomas were found on adrenal CT in 25% of cases, and adenomas in 31.2%. From a therapeutic point of view, surgery took first place in these cases: trans-sphenoidal adenomectomy for adrenocortical adenomas and adrenalectomy for adrenal tumors. Adrenalectomy was also indicated in two cases of ACTH-dependent hypercorticism (Cushing's disease and paraneoplastic) ......