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. 2021 Sep;73(3):674-681.
doi: 10.1007/s12020-021-02707-z. Epub 2021 Apr 5.

Chemosensory dysfunction in Cushing's syndrome

Elena Heger  1 , German Rubinstein  1 , Leah T Braun  1 , Stephanie Zopp  1 , Jürgen Honegger  2 , Max Seidensticker  3 , Martin Reincke  1 , Andrea Oßwald  4
Affiliations

Chemosensory dysfunction in Cushing's syndrome

Elena Heger et al. Endocrine. 2021 Sep.

Abstract

Purpose: Cushing's syndrome (CS) can lead to structural changes in the brain and cognitive impairment, but chemosensory function has not been investigated yet. The aim was to analyze sense of smell and taste in patients with CS and explore the effect of therapy.

Methods: The study cohort comprised 20 patients with florid CS treated between 2018 and 2020 in the outpatient clinic of the LMU Munich. We compared these 20 patients with CS to 40 healthy subjects matched for age, sex, and smoking status. Patients' sense of smell and taste was examined at diagnosis and 3 months after successful therapeutic surgery leading to clinical and biochemical remission. Odor threshold, discrimination, and identification were measured with "Sniffin' Sticks", taste was measured with "Taste Strips". Perceived sense of smell and taste was retrieved via a questionnaire.

Results: Patients with florid CS had significantly reduced smell (total smell score 30.3 vs. 34.4, p < 0.0005) and taste scores (9.5 vs. 12.0, p < 0.0005) compared to controls and significantly more frequently hyposmia (55 vs. 2.5%, p < 0.0005), hypogeusia (40 vs. 0%, p < 0.0005), and self-reported chemosensory impairment (60 vs. 0%, p < 0.0005). Three months after successful surgery, CS patients showed significant improvement of odor threshold (8.1 vs. 7.0, p < 0.0005), odor discrimination (12.0 vs. 11.0, p = 0.003), total smell score (33.4 vs. 30.3, p < 0.0005), and taste (11.5 vs. 9.5, p = 0.003).

Conclusions: Chemosensory dysfunction is a novel and clinically relevant feature of CS.

Keywords: ACTH; Cortisol; Cushing’s disease; “Sniffin’ Sticks”; “Taste Strips”.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Effect of surgery on smell and taste of individual CS patients. TDI total smell score, CD Cushing’s disease, CPA cortisol producing adenoma, ECS ectopic Cushing’s syndrome. Effect of surgery on smell (a) and taste (b) of individual CS patients. TDI total smell score, CD Cushing’s disease, CPA cortisol producing adenoma, ECS ectopic Cushing’ssyndrome
Fig. 2
Fig. 2
Correlations between objective and subjective impairment of smell and taste in CS patients. Correlations between objective and subjective impairment of smell (a) and taste (b) in CS patients
See this image and copyright information in PMC

References

    1. Clayton R, Jones P, Reulen R, Stewart P, Hassan-Smith Z, Ntali G, Karavitaki N, Dekkers O, Pereira A, Bolland M, Holdaway I, Lindholm J. Mortality in patients with Cushing’s disease more than 10 years after remission: a multicentre, multinational, retrospective cohort study. Lancet Diabetes Endocrinol. 2016;4(7):569–576. doi: 10.1016/S2213-8587(16)30005-5. - DOI - PubMed
    1. Santos A, Resmini E, Crespo I, Pires P, Vives-Gilabert Y, Granell E, Valassi E, Gómez-Anson B, Martínez-Momblán M, Mataró M, Webb S. Small cerebellar cortex volume in patients with active Cushing’s syndrome. Eur. J. Endocrinol. 2014;171(4):461–469. doi: 10.1530/EJE-14-0371. - DOI - PubMed
    1. Chen Y-F, Li Y-F, Chen X, Sun Q-F. Neuropsychiatric disorders and cognitive dysfunction in patients with Cushing’s disease. Chin. Med J. (Engl.) 2013;126(16):3156–3160. - PubMed
    1. Pivonello R, Isidori A, De Martino M, Newell-Price J, Biller B, Colao A. Complications of Cushing’s syndrome: state of the art. Lancet Diabetes Endocrinol. 2016;4(7):611–629. doi: 10.1016/S2213-8587(16)00086-3. - DOI - PubMed
    1. Mancini T, Porcelli T, Giustina A. Treatment of Cushing disease: overview and recent findings. Ther. Clin. Risk Manag. 2010;6:505–516. doi: 10.2147/TCRM.S12952. - DOI - PMC - PubMed

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