From first symptoms to final diagnosis of Cushing's disease: experiences of 176 patients

Kreitschmann-Andermahr I, Psaras T, Tsiogka M, Starz D, Kleist B, Siegel S, Milian M, Kohlmann J, Menzel C, Fuehrer-Sakel D, Honegger J, Sure U, Mueller O, Buchfelder M (2015)

Publication Type: Journal article

Publication year: 2015

Journal

European Journal of Endocrinology BioScientifica

Book Volume: 172

Pages Range: 285-9

Journal Issue: 3

DOI: 10.1530/EJE-14-0766

Abstract

To obtain structured information on the diagnostic delay in patients with Cushing's disease (CD) from the patients perspective to provide leverage points for earlier diagnosis.The study includes 176 patients with ACTH-dependent CD who had received pituitary surgery completed a self-developed questionnaire on their symptomatology before the illness was diagnosed, the course and length of the diagnostic process, and the role of the involved health care professionals.Data were analyzed statistically. Answers in free text options were categorized and counted.The overall diagnostic process took 3.8±4.8 years (median 2 years), during which 4.6±3.8 (1-30) physicians were consulted, most frequently the family physician (FP; 83.0%). The presented symptoms were various and often vague, e.g. 'poor general condition' (at FPs), or very common in the field of the visited specialist (i.e. 'skin changes' at dermatologists). Women recognized the first CD symptoms themselves significantly more frequently than men, whereas physicians recognized CD symptoms significantly more frequently in males.A clear difficulty of diagnosing CD seems that patients describe isolated symptoms to the FP or the respective specialists according to their fields of specialization. As FPs are contacted most frequently, they should be trained to recognize the broad spectrum of CD symptoms, especially in female patients with weight gain, and initiate endocrinological referral.

Authors with CRIS profile

Daniel Starz Department of Neurosurgery Johannes Kohlmann Department of Neurosurgery Michael Buchfelder Lehrstuhl für Neurochirurgie

Involved external institutions

Eberhard Karls Universität Tübingen DE Germany (DE) Krankenhaus Köln-Merheim - Klinikum der Universität Witten/Herdecke DE Germany (DE) Universität Duisburg-Essen (UDE) DE Germany (DE)

How to cite

APA:

Kreitschmann-Andermahr, I., Psaras, T., Tsiogka, M., Starz, D., Kleist, B., Siegel, S.,... Buchfelder, M. (2015). From first symptoms to final diagnosis of Cushing's disease: experiences of 176 patients. European Journal of Endocrinology, 172(3), 285-9. https://doi.org/10.1530/EJE-14-0766

MLA:

Kreitschmann-Andermahr, Ilonka, et al. "From first symptoms to final diagnosis of Cushing's disease: experiences of 176 patients." European Journal of Endocrinology 172.3 (2015): 285-9.

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