Cushing's syndrome

Cushing’s syndrome (CS) is a constellation of findings caused by hypercortisolism.

The most common cause of Cushing's syndrome (CS) is iatrogenic (administration of exogenous steroids).

Cushing's syndrome is a rare disease that is caused by the over production of cortisol by the adrenal glands.

Adrenocorticotropin hormone (ACTH)-dependent Cushing's syndrome is caused by Cushing's disease (around 85%) and ectopic ACTH-secreting tumors (approximately 15%) 1).

This can be caused by a tumor of the adrenal glands, the lungs, or the pituitary gland. When the tumor produces too much ACTH, it causes over production of cortisol by the adrenal glands. If the source is the pituitary, it is called Cushing's disease 2)

Expert opinion and a consensus statement on Cushing syndrome (CS) indicate that, in a patient with a clinical presentation and biochemical studies consistent with a pituitary etiology, the presence of a pituitary tumor ≥6 mm is highly suggestive of Cushing disease (CD).

This is most often as a result of Pituitary corticotroph adenoma.

Definite treatment of Cushing's syndrome is surgical removal of ACTH-secreting lesion and prerequisite for this surgical management requires localization of ACTH-secreting source 3).


1)
Stewart PM, Krone NP. 12th ed. Philadelphia: Elsevier Saunders; 2011. The Adrenal Cortex. Williams Text Book of Endocrinology; pp. 479–544.
2)
Gardner D, editor. New York: The McGraw-Hill Company; 2007. Greenspan's Basic and Clinical Endocrinology (eight edition Ed.
3)
Katznelson L, Bogan JS, Trob JR, Schoenfeld DA, Hedley-Whyte ET, Hsu DW, et al. Biochemical assessment of Cushing's disease in patients with corticotroph macroadenomas. J Clin Endocrinol Metab. 1998;83:1619–23.
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