Hematological changes in Cushing’s disease from diagnosis to remission: comparison with non-functioning pituitary adenomas
Endokrynologia Polska, cilt.77, sa.4, ss.319-326, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 77 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.5603/ep.111457
- Dergi Adı: Endokrynologia Polska
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.319-326
- Anahtar Kelimeler: Cushing's disease, hypercortisolism, complete blood count, neutrophil-to-lymphocyte ratio, leukocytosis
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Cushing’s disease (CD) results in chronic hypercortisolism with multisystem complications. Although glucocorticoids affect hematopoiesis, sex-specific hematological alterations and their reversibility following treatment remain incompletely characterized. Most previous studies have compared patients with CD with healthy controls, limiting the ability to isolate cortisol-specific effects from tumor- or surgery-related confounders. We investigated hematological parameters in patients with CD at diagnosis and after remission, using patients with non-functioning pituitary adenoma (NFA) as controls to specifically identify hypercortisolism-driven changes. Material and methods: This retrospective study included 117 patients: 59 with CD and 58 with NFA who underwent transsphenoidal surgery. Complete blood count and hormonal parameters were evaluated at diagnosis and 3 months postoperatively. Changes in hematological parameters were compared between groups using repeated-measures analysis of variance, with subgroup analyses examining remission status and sex-specific differences. Results: At baseline, patients with CD showed significantly elevated white blood cells (WBC) counts (9.50 ± 2.67 vs. 7.32 ± 1.71 × 10^3/μL, p < 0.001), neutrophil counts (6.41 ± 2.35 vs. 4.30 ± 1.44 × 10^3/μL, p < 0.001), neutrophil-to-lymphocyte ratio (NLR) (3.27 ± 2.03 vs. 2.04 ± 0.91, p < 0.001), and red blood cells (RBC) counts (4.70 ± 0.50 vs. 4.51 ± 0.46 × 10^6/μL, p = 0.03), with significantly lower eosinophil counts (0.111 ± 0.093 vs. 0.166 ± 0.140 × 10^3/μL, p = 0.01) compared with NFA patients. No sex-specific differences were observed in baseline hematological parameters within the CD group. At 3 months postoperatively, significant decreases in hemoglobin (p = 0.02), WBC (p < 0.001), neutrophil counts (p < 0.001), and NLR (p = 0.006) were observed in patients with CD compared with NFA controls. Importantly, the magnitude of postoperative reductions in WBC (p = 0.01) and neutrophil counts (p = 0.009), as well as increases in eosinophil counts (p = 0.03), was significantly associated with achieving biochemical remission. Neutrophil recovery was greater in women (p = 0.03). No correlations were found between baseline cortisol levels and hematological parameters. Conclusions: Cushing’s disease demonstrates specific hematological alterations — elevated WBC, neutrophils, NLR, and RBC, with decreased eosinophils — that are attributable to hypercortisolism rather than the presence of a pituitary tumor. These parameters normalize rapidly following surgical remission, with changes correlating with biochemical cure. Routine complete blood counts may serve as accessible biomarkers for monitoring disease activity and treatment response in CD.