Please register or login to view the chart

Cushing’s syndrome – Quick revision card

Adrenal gland hyperfunction Cortisol made by the central zone or zona fasciculate

 

Prolonged exposure to high circulating levels of cortisol is Cushing’s syndrome

 

Exogenous – prolonged use of glucocorticoids

Endogenous – excessive cortisol production by adrenal glands – this can be ACTH dependent ( majority 80 % ) or ACTH independent ( due to benign or malignant adrenal tumors )

 

ACTH secreting pituitary tumors is called Cushing’s disease Ectopic ACTH secretion by neoplasms

 

Cushing’s Disease
 most frequent cause of Cushing’s syndrome
 ACTH ( adrenocorticotrophic hormone ) hypersecretion due to a corticotroph adenoma causing corticol hypersecretion

 

Cortisol excess – obesity ( centripetal ) facial plethora , rounded face , buffalo hump fatigue , weakness protein wasting ( thin skin , abdominal purple to red and wide cutaneous striae , east bruising , slow healing , muscle wasting ) osteoporosis ( bone wasting leading to fractures ) raised blood pressure depression , mood swings , emotional reactivity loss of libido , erectile dysfunction in men , irregular menstrual cycle , infertility , hyperhidrosis , hirsutism impaired immunity ( repeated infections ) back pain

 

R/O exogenous sources mild hypokalaemia may be noted due to mineralocorticoid effect of steroids verification of endogenous hyercortisonilism by tests as
○ late night salivary cortisol
○ 24 hr urine free cortisol
○ low dexamethasone suppression test

REFERENCES

  1. Chaudhry HS, Singh G. Cushing Syndrome. [Updated 2021 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022  Available from: https://www.ncbi.nlm.nih.gov/books/NBK470218/
  2. Lynnette K. Nieman, Beverly M. K. Biller, James W. Findling, John Newell-Price, Martin O. Savage, Paul M. Stewart, Victor M. Montori, The Diagnosis of Cushing’s Syndrome: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 5, 1 May 2008, Pages 1526–1540, https://doi.org/10.1210/jc.2008-
  3. Castinetti, F., Morange, I., Conte-Devolx, B. et al. Cushing’s disease. Orphanet J Rare Dis 7, 41 (2012). https://doi.org/10.1186/1750-1172-7-41
  4. Lonser RR, Nieman L, Oldfield EH. Cushing’s disease: pathobiology, diagnosis, and management. J Neurosurg. 2017 Feb;126(2):404-417. doi: 10.3171/2016.1.JNS152119. Epub 2016 Apr 22. PMID: 27104844.

Share

Related Charts:

Add Your Comments

Your email address will not be published.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

A4 Medicine  - Search Less and Learn More

Welcome to the A4 medicine community where we are constantly working to provide exceptional educational material to primary health care professionals. Subscribe to our website for complete access to our A4 Charts. They are aesthetically designed charts that contain 300 (plus and adding) common and complex medical conditions with the all information required for primary care in one single page that can help you in consultation/practice and exam.

Additionally, you will get complete access for our Learn From Experts : A4 Webinar Series in which domain experts share the video explainer presentation on one medical condition in one hour for the primary care. And you will also get a hefty discount on our publications and upcoming digital products.

We are giving a lifetime flat 30% discount to our first thousand users, discount code already applied to checkout.