Coagulation Profile Dynamics in Pediatric Patients with Cushing Syndrome: A Prospective, Observational Comparative Study

• Published in: The Journal of pediatrics 2016-10, Vol.177, p.227-231
• Main Authors: Birdwell, Leah, BS, Lodish, Maya, MD, MHSc, Tirosh, Amit, MD, Chittiboina, Prashant, MD, Keil, Meg, PhD, Lyssikatos, Charlampos, MD, Belyavskaya, Elena, MD, Feelders, Richard A., MD, Stratakis, Constantine A., MD, D(Med)Sci
• Format: Article
• Language: English
• Subjects: Adolescent; blood clot; Cushing Syndrome - blood; Cushing Syndrome - complications; Cushing Syndrome - surgery; Female; Humans; hypercoagulable state; Male; Pediatrics; Prospective Studies; Retrospective Studies; thromboembolic event; Thrombophilia - etiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2016.06.087

Objective To evaluate the association between Cushing syndrome and hypercoagulability in children. Study design A prospective, observational study was performed of 54 patients with Cushing syndrome, 15.1 ± 3.9 years, treated at the National Institutes of Health Clinical Center. Coagulation profiles were taken before and 6-12 months after surgery and compared with18 normocortisolemic children, 13.7 ± 3.6 years. Results At baseline, patients with Cushing syndrome had greater levels of the procoagulant factor VIII (FVIII) vs controls (145 IU/dL ± 84 vs 99 ± 47, P  = .04); 6-12 months after surgery, FVIII levels decreased to 111 ± 47, P  = .05. Patients with Cushing syndrome had greater levels of the antifibrinolytic α2-antiplasmin, 96 ± 17% vs 82 ± 26%, P  = .015. After surgery, antifibrinolytic α2-antiplasmin levels decreased to 82 ± 24%, P