Treatment of Cushing's Disease in Children Under 18 Years of Age

Cushing's disease (CD) in pediatric patients is a rare but serious condition. The clinical presentation and management in this age group warrant specific consideration, as the underlying causes and therapeutic priorities differ from those seen in adults.

Clinical Scenario

Endogenous Cushing's syndrome is extraordinarily rare before age 18. In children over age 6, Cushing's disease is the most common underlying cause, while adrenal causes predominate in younger children. This protocol applies specifically to patients under 18 years of age diagnosed with Cushing's disease.

Treatment Approach

First-line management involves a surgical approach targeting the source of excess ACTH. The complete treatment algorithm — including sequencing, patient-specific considerations, and follow-up — is available in the full structured regimen.

Full regimen details, including clinical decision points and monitoring targets, are accessible via the link below.

Clinical Goal

The primary therapeutic target is recovery of adrenal function, which typically occurs within approximately 12 months following successful treatment.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/S2213-8587(21)00235-7

Endogenous CS is extraordinarily rare before age 18.
In children over age 6, CD is the most common cause of CS, while adrenal causes are more common in younger children.
As in adults, surgical resection of the ACTH-secreting tumor is the first-line treatment.
With successful treatment, adrenal function typically recovers within approximately 12 months.

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