cushing's%20syndrome
CUSHING'S SYNDROME
Cushing’s syndrome is a condition which is due to prolonged exposure of the body tissue to excess cortisol (glucocorticoid hormone).
Laboratory tests and radiological findings confirm diagnosis and determine the actual cause of Cushing's syndrome.
Endogenous adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome has adrenal hypersecretion due to adrenal adenoma, adrenal carcinoma, micronodular hyperplasia, and macronodular hyperplasia.
Exogenous ACTH-independent Cushing's syndrome has adrenal hypersecretion due to iatrogenic causes (eg drug-induced, corticosteroid use).

Definition

Cushing’s syndrome: 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

  • Truncal obesity
  • Plethora
  • “Moon” face
  • Acne
  • Easy bruising
  • Violaceous striae width >1 cm
  • Buffalo hump
  • Sudden weight gain
  • Hirsutism (in women)
  • Muscle weakness
  • Decreased libido & impotency (in men)
  • Infection
  • Depression/lethargy
  • Menstrual disorders

Associated Clinical Conditions

  • Osteoporosis
  • Hypertension
  • DM/impaired glucose tolerance
  • Hyperlipidemia
  • Polycystic ovary syndrome (PCOS)
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 20 Jul 2018
Women with pre-eclampsia or gestational hypertension during their first pregnancy had an increased risk of developing chronic hypertension, type 2 diabetes (T2D), and hypercholesterolaemia than those who were normotensive during pregnancy, according to a study. The risk persisted for several decades later, signalling these hypertensive disorders of pregnancy (HDP) as red flags for cardiovascular (CV) health for life.
Roshini Claire Anthony, 30 Jul 2018

Canagliflozin may provide a renoprotective effect in individuals with type 2 diabetes (T2D) and a history of cardiovascular disease (CVD), according to results from the CANVAS* Program.

Stephen Padilla, 31 Jul 2018
Patients with type 2 diabetes (T2D) treated with sulphonylureas as second-line drugs are at an increased risk of myocardial infarction (MI), all-cause mortality and severe hypoglycaemia compared with those who remained on metformin monotherapy, a recent study has found.
22 Jul 2018
There appears to be a nonlinear relationship between total oestradiol and free oestradiol and all-cause mortality among older men, according to data from the Three-City cohort study. Specifically, the association is stronger for cardiovascular disease mortality and nonexistent for cancer mortality.