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Cushing Disease and Cushing Syndrome

Reviewed 06/2020
 


BASICS

DESCRIPTION

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

  • Exogenous intake of ...

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

Treatment is essential to reduce mortality and associated comorbidities. 

MEDICATION

  • Drugs usually not effective for long-term treatment; used in preparation for surgery or as adjunctive after...

ONGOING CARE

PATIENT EDUCATION

Education of patients and family about disease, treatment options, and expectations, as well as education about diet and monitoring daily weight, early treatment of infec...

REFERENCES

1
Wannachalee T, Turcu AF, Bancos I, et al. The clinical impact of [68 Ga]-DOTATATE PET/CT for the diagnosis and management of ectopic adrenocorticotropic hormone-secreting tumours. Clin End...

ADDITIONAL READING

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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