Abstract
Cushing disease (CD) causes a wide variety of nonspecific symptoms, which may result in delayed diagnosis. It may be possible to uncover unusual combinations of otherwise common symptoms using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Our aim was to identify and evaluate dyads of clinical symptoms or conditions associated with CD. We conducted a matched case-control study using a commercial healthcare insurance claims database designed to compare the relative risk (RR) of individual conditions and dyad combinations of conditions among patients with CD versus matched non-CD controls. With expert endocrinologist input, we isolated 10 key conditions (localized adiposity, hirsutism, facial plethora, polycystic ovary syndrome, abnormal weight gain, hypokalemia, deep venous thrombosis, muscle weakness, female balding, osteoporosis) with RRs varying from 5.3 for osteoporosis to 61.0 for hirsutism (and infinite RR for localized adiposity). The RRs of dyads of these conditions ranged from 4.1 for psychiatric disorders/serious infections to 128.0 for hirsutism/fatigue in patients with versus without CD. Construction of uncommon dyads resulted in further increases in RRs beyond singl...Continue Reading
References
Apr 1, 1994·Clinical Endocrinology·J Etxabe, J A Vazquez
Mar 19, 2003·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Brenda MotheralPaul Stang
Apr 27, 2005·Endocrinology and Metabolism Clinics of North America·James W Findling, Hershel Raff
May 3, 2005·Journal of Clinical Epidemiology·Sebastian Schneeweiss, Jerry Avorn
May 16, 2006·Lancet·John Newell-PriceLynnette K Nieman
Jul 26, 2006·European Journal of Internal Medicine·Marie MullerOlivier Chabre
Jan 4, 2007·The Journal of Clinical Endocrinology and Metabolism·O M DekkersJ A Romijn
May 3, 2007·Internal Medicine·Ai YoshiharaKazue Takano
Mar 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Lynnette K NiemanVictor M Montori
Sep 21, 2010·Neuroendocrinology·Charlotte SteffensenJens Otto Lunde Jørgensen
Dec 21, 2010·Methods of Information in Medicine·S ConcaroR Bellazzi
May 4, 2011·Journal of Medical Systems·Illhoi YooLei Hua
Jul 1, 2011·European Journal of Endocrinology·Elena ValassiUNKNOWN ERCUSYN Study Group
Sep 9, 2011·PLoS Computational Biology·Francisco S RoqueSøren Brunak
Mar 10, 2012·Journal of the American Board of Family Medicine : JABFM·Federica Guaraldi, Roberto Salvatori
Mar 17, 2012·Reumatología clinica·Nadia Abdel-KaderAna González
Jun 26, 2012·European Journal of Endocrinology·R A FeeldersA M Pereira
Jan 25, 2013·The Journal of Clinical Endocrinology and Metabolism·Richard A Feelders, Leo J Hofland
May 9, 2013·JAMA : the Journal of the American Medical Association·Bridget M Kuehn
Jul 20, 2013·Annals of General Psychiatry·Alice TangPeter Campbell
May 8, 2014·Pituitary·Michael S BroderWilliam H Ludlam
May 29, 2014·Journal of Diabetes Research·Michael E MunsonDavid A Hanauer
Citations
Jan 18, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Michael S BroderMaureen P Neary
Jan 11, 2017·Journal of Clinical Pathology·Joseph M PappachanFahmy W Hanna
Apr 18, 2017·Case Reports in Dermatology·Emily G LefkowitzJohn B Fournier
Mar 29, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Katalin Meszaros, Attila Patocs