PMC6813230_01
Growth chart of the patient with cyclic Cushing's disease.
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F1
Her mid-parental height (MPH) was between the 50th and 75th percentiles (Figure 1).
Body mass chart of the patient with cyclic Cushing's disease.
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F2
Retrospective analysis of her growth chart showed inhibition of her growth velocity during last 3 years from 25 percentile to -2.4 SD, with rapid development of obesity (only during last year from +9% to +57%), varying in time (Figure 2).
Pictures of the patient with cyclic Cushing's disease in symptomatic hypercortisolemia at the age 7 2/12 years, followed by remission at the age 7 8/12 years and in the relapse period at the age 8 6/12 years.
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F3
The photos of the girl presented by her mother revealed cyclic changes of her appearance in previous several months (Figure 3). Obesity was visible mainly on her face, neck, and abdomen, with areas of acanthosis nigricans on her neck (Figure 3), hirsutism on her back, thighs and above her upper lip.
MR image of the hypothalamic-pituitary area with contrast with visible pituitary adenoma in the patient with cyclic Cushing's disease in the second relapse period (clinical and biochemical hypercortisolemia at the age of 8 6/12 years).
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F4
MRI of the pituitary, repeated 6 months after the previous, which was normal, revealed an area of reduced signal that measured 3 x 4 mm located in the right-sided part of the anterior pituitary gland (Figure 4).