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

Empagliflozin not just another SGLT2i: Cardio-renal benefits extend to HF with or without diabetes

Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Navigating the CPP patient journey – case-based discussion for nurses

06 May 2021

In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.

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.