Cushing syndrome

Cushing syndrome

Hypercortisolism A condition characterized by excess corticosteroids, due either to an hypersecretion of cortisol by a hyperfunctioning or neoplastic adrenal cortex, or due to exogenous corticosteroids Etiology Exogenous coticosteroid administration; less commonly, pituitary hyperplasia, adenomas, or cancer Clinical Amenorrhea, hirsutism, HTN, impotence, muscular wasting, skin atrophy, neuropsychiatric dysfunction, osteoporosis, truncal–central obesity, weight gain–water retention, moon face, weakness, fatigue, backache, headache, ↑ thirst, ↑ urination, DM, osteoporosis Lab Hypersecretion of cortisol, loss of the usual circadian rhythm of ACTH and cortisol, and loss of suppressibility of cortisol production by administration of dexamethasone; ↑ adrenal androgens suppresses pituitary output of LH and FSH and causes ↓ sperm production or ovulatory failure Management Surgical excision if tumor is ID'd. See Dexamethasone suppression test, Ectopic hormone syndrome. Cf Pseudo-Cushing syndrome.