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Cushing Disease and Cushing Syndrome

Linda Paniagua, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Clinical abnormalities associated with chronic exposure to excessive amounts of cortisol (the major adrenocorticoid)

  • Cushing syndrome is defined as excessive corticosteroid exposure f...

DIAGNOSIS

HISTORY

  • Weight gain: 95%

  • Decreased libido: 90%

  • Menstrual irregularity: 80%

  • Depression/emotional lability: 50–80%

  • Easy bruising: 95%

  • Diabetes or glucose intolerance: 90%

PHYSICAL EXAM

  • Obesity (usuall...

TREATMENT

MEDICATION

  • Drugs usually not effective for primary long-term treatment; used in preparation for surgery or as adjunctive treatment after surgery, pituitary radiotherapy, or both

  • Metyrapone, ke...

ONGOING CARE

PATIENT EDUCATION

  • Teaching regarding diet and monitoring daily weight, early treatment of infections, emotional lability

  • National Adrenal Disease Foundation. Great Neck, NY 11021; 519-407-4...

REFERENCES

1
1 Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab.  2008;93(5):1526–1540.
2
2 Pu...

SEE ALSO

Algorithm: Cushing Syndrome 

CODES

ICD10

  • E24.9 Cushing’s syndrome, unspecified

  • E24.0 Pituitary-dependent Cushing’s disease

  • E24.2 Drug-induced Cushing’s syndrome

  • E24.8 Other Cushing’s syndrome

  • E24.4 Alcohol-induced pseudo-Cushing’s syn...

CLINICAL PEARLS

  • Cushing disease is due to excessive ACTH secretion from a pituitary tumor, resulting in corticosteroid excess.

  • Cushing syndrome is due to excessive corticosteroid exposure from exogenou...

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