Ilonka Kreitschmann-Andermahr1, Tsambika Psaras2, Maria Tsiogka2, Daniel Starz2, Bernadette Kleist2, Sonja Siegel3, Monika Milian2, Johannes Kohlmann2, Christa Menzel2, Dagmar Führer-Sakel2, Jürgen Honegger2, Ulrich Sure2, Oliver Müller2, Michael Buchfelder2. 1. Department of NeurosurgeryUniversity Hospital Essen, University of Essen-Duisburg, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of NeurosurgeryHospital of Cologne-Merheim, Cologne, GermanyDepartment of EndocrinologyUniversity of Essen-Duisburg, Essen, GermanyDepartment of NeurosurgeryUniversity of Erlangen-Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Tuebingen, Tuebingen, Germany ilonka.kreitschmann@uk-essen.de. 2. Department of NeurosurgeryUniversity Hospital Essen, University of Essen-Duisburg, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of NeurosurgeryHospital of Cologne-Merheim, Cologne, GermanyDepartment of EndocrinologyUniversity of Essen-Duisburg, Essen, GermanyDepartment of NeurosurgeryUniversity of Erlangen-Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Tuebingen, Tuebingen, Germany. 3. Department of NeurosurgeryUniversity Hospital Essen, University of Essen-Duisburg, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of NeurosurgeryHospital of Cologne-Merheim, Cologne, GermanyDepartment of EndocrinologyUniversity of Essen-Duisburg, Essen, GermanyDepartment of NeurosurgeryUniversity of Erlangen-Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Tuebingen, Tuebingen, Germany Department of NeurosurgeryUniversity Hospital Essen, University of Essen-Duisburg, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of NeurosurgeryHospital of Cologne-Merheim, Cologne, GermanyDepartment of EndocrinologyUniversity of Essen-Duisburg, Essen, GermanyDepartment of NeurosurgeryUniversity of Erlangen-Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Tuebingen, Tuebingen, Germany.
Abstract
OBJECTIVE: 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. DESIGN: 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. METHODS: Data were analyzed statistically. Answers in free text options were categorized and counted. RESULTS: 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. CONCLUSION: 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.
OBJECTIVE: 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. DESIGN: 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. METHODS: Data were analyzed statistically. Answers in free text options were categorized and counted. RESULTS: 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. CONCLUSION: 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: Elena Valassi; Iacopo Chiodini; Richard A Feelders; Cornelie D Andela; Margueritta Abou-Hanna; Sarah Idres; Antoine Tabarin Journal: Endocr Connect Date: 2022-06-24 Impact factor: 3.221
Authors: Z Karaca; S Taheri; S T Firat; M Borlu; G Zararsiz; E Mehmetbeyoglu; A Sezgin Caglar; A Hacioglu; F Tanriverdi; K Unluhizarci; F Kelestimur Journal: J Endocrinol Invest Date: 2020-05-14 Impact factor: 4.256