Cushing's syndrome clinical features

Chronic exposure to hypercortisolism may be related to iron distribution and significantly correlated with altered brain volumes and clinical features in patients with Cushing's Disease 1).


Obesity. fatty deposits, especially in the midsection, the face (causing a round, moon-shaped face), and between the shoulders and the upper back (causing a buffalo hump) purple stretch marks on the breasts, arms, abdomen, and thighs. thinning skin that bruises easily

Cushing's syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol.

Psychiatric complications of Cushing's syndrome include irritability, anxiety, depressed mood, and cognitive impairment. Psychosis is a rare manifestation of Cushing's syndrome; therefore, the literature on the subject is limited and consists mainly of clinical case reports. We report a case of Cushing's syndrome misdiagnosed as schizophrenia-like psychosis for more than 10 years. Transsphenoidal adenomectomy resulted in amelioration of psychiatric symptoms as well as improvement of cognitive ability. Clinicians should consider the presence of psychiatric symptoms predating the diagnosis of Cushing's syndrome, especially when these symptoms are persistent and treatment-resistant, as seen in the present case 2).


1)
Jiang H, Li Z, Yang W, Sun Y, Yan F, Sun Q, Wei H, Bian L. Region-Specific Disturbed Iron Redistribution in Cushing's Disease Measured by MRI-based Quantitative Susceptibility Mapping. Clin Endocrinol (Oxf). 2022 Feb 16. doi: 10.1111/cen.14692. Epub ahead of print. PMID: 35170794.
2)
Fujii Y, Mizoguchi Y, Masuoka J, Matsuda Y, Abe T, Anzai K, Kunitake Y, Tateishi H, Inaba T, Murakawa T, Kato TA, Monji A. Cushing's Syndrome and Psychosis: A Case Report and Literature Review. Prim Care Companion CNS Disord. 2018 Sep 13;20(5). pii: 18br02279. doi: 10.4088/PCC.18br02279. PubMed PMID: 30256544.
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