Cushing's%20syndrome Signs and Symptoms

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

NCDs continue with march in the shadow of COVID-19

Pank Jit Sin, 02 Sep 2020

The most recent report by the National Health and Morbidity Survey (NHMS) 2019 proved to be a blow to public health in Malaysia. Even with consistent, unrelenting efforts by stakeholders and policymakers, the figures for NCDs continue to climb. MIMS Doctor reached out to the Director-General of Health Tan Sri Dato' Seri Dr Noor Hisham Abdullah to get up to date with the COVID-19 situation in the country and to obtain his thoughts on the ramifications of the findings.

Empagliflozin: Another SGLT-2i in HFrEF armamentarium

Roshini Claire Anthony, 05 Nov 2020

Adding empagliflozin to recommended therapy in patients with heart failure with reduced ejection fraction (HFrEF) reduced the risk of HF hospitalization and slowed renal function decline, the EMPEROR-Reduced* trial showed.

Empagliflozin’s clinical endorsement: Revolutionising guidelines across specialties

08 Jun 2020

In this third issue we take a look at how empagliflozin made a bold impact on clinical guidelines across multiple specialties. We will explore how existing treatment recommendations were altered, and summarise the current guidelines and future perspectives of empagliflozin’s use.