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Cushing Disease and Cushing Syndrome

Husna Khan, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Cushing syndrome is defined as excessive glucocorticoid exposure from exogenous (steroid medications) or less commonly from endogenous sources (pituitary, adrenal, pulmonary, etc.).

  • C...

DIAGNOSIS

HISTORY

  • Weight gain: 95%

  • Decreased libido: 90%

  • Menstrual irregularity: 80%

  • Depression/emotional lability: 50–80%

  • Easy bruising: 95%

  • Diabetes or glucose intolerance: 90%

  • Classical features may be ab...

TREATMENT

Surgical resection once the cause has been established is the most effective treatment. 

MEDICATION

  • Medical therapy is usually ineffective for long-term treatment; used in preparation for surg...

ONGOING CARE

PATIENT EDUCATION

Education about diet and monitoring daily weight, early treatment of infections and emotional lability 

PROGNOSIS

  • Generally chronic course with cyclic exacerbations and rar...

REFERENCES

1
Nieman LK, Biller BMK, Findling JW, et al. Treatment of Cushing’s syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100:2807–2831.
2
Wannachalee T, Tu...

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.

  • Cushing syndrome is due to excessive corticosteroid exposure from exogenous sources (medications) or endogenou...

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