As James Findling (11) once said, "if you have never missed the diagnosis of ACTH-dependent Cushing syndrome, and you have never been fooled attempting to establish its cause, you should refer your patients with suspected hypercortisolism
to somebody who has" (personal communication).
results in multiple medical problems, including hypertension, obesity, osteoporosis, fractures, impaired wound healing, infectious diseases, glucose intolerance, and psychosis.
Research by Gold and George Chrousos of the National Institute of Child Health and Human Development--a coauthor of the NEJM paper with Gold and Frederic Goodwin, director of the Alcohol, Drug Abuse and Mental Health Administration -- suggests this hypercortisolism
is indirectly caused by an overproduction of CRH and therefore by an activation of the stress circuits in the brain and body.
In our series, 1 patient with myelolipoma had central obesity and hypercortisolism
and the EU as a once-daily oral medication for the treatment of hyperglycemia secondary to hypercortisolism
in adults suffering from endogenous Cushing's syndrome, who have type II diabetes or glucose intolerance.
However, over the course of the next 2-3 weeks ACTH and cortisol returned to pre-procedure levels and the patient once again suffered from the effects of hypercortisolism
Other endocrine disorders that can contribute to hypertriglyceridemia are acromegaly, hypothyroidism, and hypercortisolism
Most studies report that conditions of FM, chronic pain, and fatigue as well as atypical depression (depression characterized by excess sleeping, increased appetite, and profound fatigue) are characterized not by hypercortisolism
, but instead decreased cortisol production and release.
also has been associated with excess levels of homocysteine, which might contribute to the prothrombotic state in such patients and their future risks of cardiovascular disease and/or venous thrombosis (13).
is a feature of both obesity and depression (12).
The dexamethasone-suppressed corticotropin-releasing hormone stimulation (LDDST-CRH)  test was initially proposed to be more accurate in confirming hypercortisolism
than the standard low-dose dexamethasone-suppression test (LDDST) for the diagnosis of Cushing syndrome (2).
Pseudo-Cushing Syndrome: Medical condition in which patients exhibit the signs and symptoms of hypercortisolism
but which is not caused by a problem with the hypothalamic--pituitary--adrenal axis.