高皮质醇血症
医学
淋巴细胞
内科学
内生
中性粒细胞绝对计数
早晨
人口
泌尿系统
免疫学
胃肠病学
氢化可的松
化疗
环境卫生
中性粒细胞减少症
作者
Christina Tatsi,Rebecca Boden,Ninet Sinaii,Meg Keil,Charalampos Lyssikatos,Elena Belyavskaya,Sergio D. Rosenzweig,Constantine A. Stratakis,Maya Lodish
摘要
BackgroundHypercortisolemia results in changes of the immune system and elevated infection risk, but data on the WBC changes in pediatric Cushing syndrome (CS) are not known. We describe the changes of the WBC lineages in pediatric endogenous hypercortisolemia, their associations with the markers of disease severity, and the presence of infections.MethodsWe identified 197 children with endogenous CS. Clinical and biochemical data were recorded. Sixty-six children with similar age and gender, and normocortisolemia served as controls.ResultsThe absolute lymphocyte count of CS patients was significantly lower than that of controls, while the total WBC and the absolute neutrophil counts were significantly higher. These changes correlated with several markers of CS severity and improved after resolution of hypercortisolemia. Infections were identified in 35 patients (17.8%), and their presence correlated to elevated serum morning cortisol, midnight cortisol, and urinary free cortisol levels, as well as with the decrease in absolute lymphocyte count.ConclusionsChildren with endogenous CS have abnormal WBC counts, which correlate with the severity of CS, and normalize after cure. Infections are common in this population; clinicians should be aware of this complication of CS and have low threshold in diagnosis and treating infections in CS.
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