Discovery of Cushing’s Syndrome After Bariatric Surgery: Multicenter Series of 16 Patients

Bradley R. Javorsky, Ty B. Carroll, Nicholas A. Tritos, Roberto Salvatori, Anthony P. Heaney, Maria Fleseriu, Beverly M.K. Biller, James W. Findling

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Purpose: The aim of this study is to demonstrate the importance of considering Cushing’s syndrome (CS) as a potential etiology for weight gain and metabolic complications in patients undergoing bariatric surgery (BS). Design and Methods: This is a retrospective chart review case series of patients (n = 16) with CS from five tertiary care centers in the USA who had BS. Results: Median age at BS surgery was 35.5 years (median 2.5 years between BS and CS surgery). CS was not identified in 12 patients prior to BS. Four patients had CS surgery prior to BS, without recognition of recurrent or persistent CS until after BS. Median body mass index (BMI) values before BS, nadir after BS, prior to surgery for CS, and after surgery for CS were 47, 31, 38, and 35 kg/m2, respectively. Prior to BS, 55 % of patients had hypertension and 55 % had diabetes mellitus. Only 17 % had resolution of hypertension or diabetes mellitus after BS. Conclusion: CS may be under-recognized in patients undergoing BS. Testing for CS should be performed prior to BS in patients with features of CS and in post-operative BS patients with persistent hypertension, diabetes mellitus, or excessive weight regain. Studies should be conducted to determine the role of prospective testing for CS in subjects considering BS.

Original languageEnglish (US)
Pages (from-to)2306-2313
Number of pages8
JournalObesity Surgery
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2015

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Keywords

  • Causes of surgical failure
  • Cushing’s syndrome
  • Hormonal causes of weight gain
  • Hypercortisolism
  • Preoperative screening for bariatric surgery
  • Weight regain after surgery

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Javorsky, B. R., Carroll, T. B., Tritos, N. A., Salvatori, R., Heaney, A. P., Fleseriu, M., Biller, B. M. K., & Findling, J. W. (2015). Discovery of Cushing’s Syndrome After Bariatric Surgery: Multicenter Series of 16 Patients. Obesity Surgery, 25(12), 2306-2313. https://doi.org/10.1007/s11695-015-1681-z