Cushing syndrome

Definition

Cushing's syndrome is a disorder that is characterized by features related to excessive endogenous and exogenous glucocorticoid exposure. Whereas Cushing's disease refers to pituitary causes, Cushing's syndrome encompasses all causes of glucocorticoid excess. The typical features of Cushing's syndrome are central obesity, fat deposits on the face, supraclavicular, and thoracocervical regions, and hirsuitism. Other abnormalities include gonadal dysfunction, depression, irritability, skin thinning and easy bruising, striae, and osteoporosis. Increased intraocular pressure and cataract development may occur. Hypertension and glucose intolerance may develop, or if already present, be exacerbated. Patients are more susceptible to infection. Diagnosis of Cushing's syndrome may be made by assessing morning cortisol levels, urinary free cortisol excretion, dexamethasone suppression test, or assessing serum ACTH levels.

Therapy

Pharmacological

Metyrapone, trilostane, ketoconazole and...