Cushing's%20syndrome Signs and Symptoms
Definition
Cushing’s syndrome is a condition which is due to prolonged exposure of the body tissue to excess cortisol (glucocorticoid hormone)
Etiology
Adrenocorticotropic Hormone (ACTH)-Independent Cushing's Syndrome
Endogenous ACTH-Independent Cushing’s Syndrome
- Adrenal hypersecretion due to adrenal adenoma, adrenal carcinoma, micronodular hyperplasia, macronodular hyperplasia
Exogenous ACTH-independent Cushing’s syndrome
- Adrenal hypersecretion due to iatrogenic causes (eg drug-induced, corticosteroid use)
Adrenocorticotropic Hormone (ACTH)-Dependent Cushing's Syndrome
Cushing’s Disease
- Due to excessive secretion of adrenocorticotropic hormone by pituitary corticotroph tumor
Ectopic Adrenocorticotropic Hormone (ACTH)/Corticotropin-Releasing Hormone (CRH) syndromes
- Ectopic adrenocorticotropic hormone syndrome is ectopic adrenocorticotropic hormone secretion due to small-cell lung carcinoma, associated with symptoms of hypertension, hypokalemia, edema, glucose intolerance
- Ectopic corticotropin-releasing hormone syndrome is ectopic corticotropin-releasing hormone secretion due mostly to bronchial carcinoid tumors
Signs and Symptoms
- Progressive obesity
- Facial obesity manifested as "moon" face
- Buffalo hump or dorsocervical fat pad
- Enlarged fat pads in the supraclavicular fossae
- Truncal obesity
- Generalized obesity
- Facial plethora
- Wasting in the extremities
- Thin skin
- Acne
- Easy bruising
- Violaceous striae width >1 cm
- Hyperpigmentation
- Hirsutism (in women)
- Proximal muscle weakness
- Impotency in men
- Changes in libido
- Menstrual disorders
- Depression/lethargy
- Central serous chorioretinopathy
- Infection
Associated Clinical Conditions
- Osteoporosis/decreased bone density
- Hypertension
- Diabetes mellitus/impaired glucose tolerance
- Hyperlipidemia
- Polycystic ovary syndrome (PCOS)
- Thromboembolism