Penyakit Cushing pada Anak

Penyakit Cushing pada Anak

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Definisi

Penyakit Cushing adalah suatu kondisi medis yang ditandai peningkatan hormon kortisol dalam tubuh selama periode waktu yang lama. Hormon kortisol memiliki beberapa fungsi penting dalam tubuh, termasuk membantu mengatasi stres dan meregulasi metabolisme glukosa. Namun, jika kortisol meningkat secara tidak normal, dapat menyebabkan berbagai masalah kesehatan. prognosis penyakit Cushing pada anak tergantung pada usia dan tingkat kerusakan yang terjadi pada tubuh. Secara umum, dengan perawatan yang tepat dan tepat waktu, banyak anak dapat mengalami pemulihan dan memiliki prognosis yang baik.

Epidemiologi penyakit Cushing pada anak belum begitu jelas, tetapi diduga bahwa angka kejadiannya relatif rendah. Penyakit Cushing pada anak dapat terjadi akibat beberapa faktor, seperti penyakit tumor pada kelenjar adrenal, gangguan hipofisis, atau konsumsi obat-obatan tertentu seperti steroid.

Gejala penyakit Cushing pada anak meliputi obesitas, perubahan dalam distribusi lemak tubuh, hipertensi, kulit yang lebih tipis dan mudah terluka, dan hilangnya otot. Beberapa anak juga mungkin mengalami masalah mood dan perilaku, seperti depresi dan agresivitas.

 

Penyebab

Penyebab penyakit Cushing pada anak dapat berasal dari berbagai sumber, di antaranya:

  • Tumor adrenal - Penyakit Cushing dapat disebabkan oleh tumor pada kelenjar adrenal yang memproduksi kortisol secara tidak normal.
  • Gangguan hipofisis - Cushing dapat terjadi jika hipofisis mengeluarkan terlalu banyak hormon ACTH yang memicu produksi kortisol oleh kelenjar adrenal.
  • Konsumsi obat-obatan steroid - Beberapa obat-obatan, seperti steroid, dapat menyebabkan tingginya tingkat kortisol dalam tubuh.

Penting untuk memahami penyebab penyakit Cushing pada anak agar dapat menentukan terapi yang tepat. Penyakit Cushing harus didiagnosis dan diterapi oleh dokter spesialis endokrin.

 

Faktor Risiko

Ada beberapa faktor risiko yang menyebabkan anak lebih mungkin untuk terkena penyakit Cushing. Faktor risiko penyakit Cushing meliputi:

  • Konsumsi obat steroid - Penggunaan jangka panjang obat steroid, seperti prednisone, dapat meningkatkan risiko terkena penyakit Cushing
  • Riwayat keluarga - Anak yang memiliki riwayat keluarga dengan penyakit Cushing memiliki risiko yang lebih tinggi untuk mengalami kondisi tersebut
  • Tipe tubuh - Orang dengan tipe tubuh yang berlebihan lemak pada bagian atas tubuh memiliki risiko yang lebih tinggi untuk mengalami penyakit Cushing
  • Riwayat penyakit kronis - Orang yang memiliki riwayat penyakit kronis, seperti diabetes, memiliki risiko yang lebih tinggi untuk terkena penyakit Cushing

 

Gejala

Gejala dan tanda penyakit Cushing pada anak dapat bervariasi, namun beberapa yang sering terjadi meliputi:

  • Pertambahan berat badan yang signifikan dan lemak yang terkonsentrasi pada bagian atas tubuh, seperti leher, dada dan pinggang
  • Pembengkakan wajah yang khas
  • Cedera dengan mudah dan memar yang sulit sembuh
  • Perubahan mood, seperti mudah tersinggung atau depresi
  • Gangguan tidur, seperti sulit tidur atau tidur yang berlebihan
  • Gangguan kulit, seperti jerawat atau ruam
  • Masalah memori dan konsentrasi
  • Kemunculan hirsutisme (pertumbuhan rambut pada bagian tubuh yang tidak biasanya)

Ini hanya beberapa gejala dan tanda yang mungkin terjadi. Gejala dan tanda penyakit Cushing pada anak dapat sangat bervariasi dan bisa sangat mirip dengan gejala lainnya. Oleh karena itu, penting untuk berkonsultasi dengan dokter untuk memastikan diagnosis yang tepat.

 

Diagnosis

Untuk mendiagnosis penyakit Cushing pada anak, dokter anak akan melakukan evaluasi medis yang komprehensif, termasuk anamnesis atau wawancara medis, pemeriksaan fisik, dan pemeriksaan penunjang berupa tes laboratorium serta bahan imaging.

Beberapa tes yang mungkin dilakukan, antara lain:

  • Tes darah: Tes ini digunakan untuk mengukur kadar hormon seperti kortisol, ACTH, dan testosteron
  • Tes urine: Tes ini digunakan untuk mengukur kadar kortisol dalam urine
  • Pencitraan: CT scan, MRI, atau pet scan dapat digunakan untuk menilai adanya tumor pada kelenjar adrenal atau hipofisis
  • Tes stimulasi: Tes ini mengukur respon hormon setelah mengonsumsi atau meminum obat tertentu
  • Tes 24 jam: Tes ini mengukur kadar kortisol dalam darah selama 24 jam

Dokter juga mungkin menggunakan tes lain untuk memastikan diagnosis dan mengeliminasi kemungkinan penyakit lain yang memiliki gejala yang mirip. Setelah diagnosis ditegakkan, dokter akan bekerja sama dengan endokrinologi anak dan ahli bedah untuk memutuskan rencana pengobatan terbaik untuk anak.

 

Tata Laksana

Tata laksana penyakit Cushing pada anak bergantung pada penyebab dasarnya. Jika penyebabnya adalah konsumsi obat-obatan, tata laksana yang diberikan yaitu dengan mengurangi atau menghentikan pengobatan yang menyebabkan peningkatan kadar kortisol. Jika penyebabnya adalah tumor, pengobatan akan melibatkan operasi untuk mengangkat tumor. Setelah operasi, anak mungkin memerlukan pengobatan tambahan, seperti terapi hormon atau obat-obatan untuk membantu memulihkan fungsi normal kelenjar adrenal.

Terapi medis lain yang mungkin diberikan untuk mengatasi gejala dan komplikasi dari penyakit Cushing termasuk terapi hormon, terapi obat, dan terapi nutrisi. Terapi hormon dapat membantu mengatur kadar hormon kortisol dan melindungi kelenjar adrenal. Terapi obat-obatan obat-obatan seperti metilprednisolon atau kortikosteroid lain dapat diberikan untuk membantu mengatasi gejala dan komplikasi dari penyakit Cushing, seperti obesitas, resistensi insulin, dan masalah dengan kondisi gula darah. Dokter anak juga dapat meresepkan obat untuk membantu mengatasi masalah psikologis, seperti stres dan depresi, yang mungkin terkait dengan penyakit ini.

Terapi nutrisi juga diberikan membantu mengatasi obesitas dan memperbaiki kadar gula darah.

 

Pencegahan

Pencegahan penyakit Cushing pada anak bisa sangat tergantung pada penyebab dasarnya. Untuk mengurangi risiko dari penyebab obat, dokter anak harus memantau anak secara teratur dan memastikan bahwa pengobatan yang diberikan tepat dan sesuai. Jika anak memiliki gejala yang mencurigakan, dokter anak harus segera mengevaluasi dan memastikan bahwa pengobatan yang diberikan sesuai dengan kebutuhan dan kondisi anak.

Menjaga pola makan sehat dan aktivitas fisik yang memadai dapat membantu mengurangi risiko penyakit Cushing, seperti obesitas dan masalah dengan kadar gula darah. Selain itu, penting untuk memantau dan mengatasi stres atau depresi yang dialami anak, karena hal ini dapat memperburuk gejala penyakit Cushing.

 

Kapan Harus ke Dokter?

Jika ada gejala yang mencurigakan, seperti pertumbuhan lambat, obesitas, masalah kulit seperti stretch marks, peningkatan rambut tubuh, hirsutisme, atau hipertensi. Jika anak mengalami peningkatan gula darah atau tekanan darah, memiliki masalah memori atau konsentrasi, atau memiliki masalah dengan libido, segera kunjungi dokter anak atau endokrinologi anak.

Jika anak memiliki faktor risiko, seperti obesitas atau riwayat pengobatan dengan obat steroid, dokter anak mungkin akan menganjurkan untuk memeriksakan diri secara berkala untuk memastikan bahwa tidak ada tanda-tanda penyakit Cushing.

 

Mau tahu informasi seputar penyakit lainnya? Cek di sini, ya!

 

 

Writer : dr Arifin Muhammad Siregar
Editor :
  • dr. Monica Salim
Last Updated : Jumat, 9 Juni 2023 | 07:20

Newell-Price, J., Bertagna, X., Grossman, A. B., Nieman, L. K., & Herington, A. C. (2006). The diagnosis and differential diagnosis of Cushing's syndrome: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 91(10), 3489-3510.

 

Nieman, L. K. (2015). Cushing's syndrome. Pediatrics in Review, 36(6), 311-320.

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      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:205
    • ActivityLogger.php#174aicare_prod_new6.07msinsert into `activity_log` (`log_name`, `properties`, `batch_uuid`, `event`, `subject_id`, `subject_type`, `description`, `updated_at`, `created_at`) values ('default', '[]', null, 'updated', 6333, 'App\\Models\\Admin\\Post', 'updated', '2025-01-13 00:50:24', '2025-01-13 00:50:24')
      Bindings
      • 0: default
      • 1: []
      • 2: 
      • 3: updated
      • 4: 6333
      • 5: App\Models\Admin\Post
      • 6: updated
      • 7: 2025-01-13 00:50:24
      • 8: 2025-01-13 00:50:24
      Backtrace
      • vendor/spatie/laravel-activitylog/src/ActivityLogger.php:174
      • vendor/spatie/laravel-activitylog/src/Traits/LogsActivity.php:88
      • app/Http/Controllers/WebController.php:779
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
    • single-post-healthpedia.blade.php#37aicare_prod_new950μsselect * from `users` where `users`.`id` = 45 limit 1
      Bindings
      • 0: 45
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.single-post-healthpedia:37
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10.01msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5905 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5905
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 4682 and `categories`.`deleted_at` is null
      Bindings
      • 0: 4682
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10.31msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2032 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2032
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 10018 and `categories`.`deleted_at` is null
      Bindings
      • 0: 10018
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10.19msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 8246 and `categories`.`deleted_at` is null
      Bindings
      • 0: 8246
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10.25msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7210 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7210
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.55msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5122 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5122
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.82msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6004 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6004
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.39msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5199 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5199
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.16msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5671 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5671
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new8.52msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6985 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6985
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#122aicare_prod_new1.06msselect * from `pages` where `slug` = 'about-us' limit 1
      Bindings
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      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:122
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#547aicare_prod_new990μsselect * from `faqs` limit 1
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:547
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      Backtrace
      • view::layouts.v2.web_layout:551
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    App\Models\Admin\Post
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    App\Models\Admin\Category
    21Category.php#?
    App\Models\Admin\Tag
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    App\Models\TermPolicy
    3TermPolicy.php#?
    App\User
    2User.php#?
    App\Models\Admin\Healthpedia
    1Healthpedia.php#?
    App\Models\Admin\Page
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