Cushing Syndrome

Cushing syndrome is chronic glucocorticoid (cortisol) excess. Clinical: central obesity, moon facies, buffalo hump, proximal-muscle weakness, wide purple striae, easy bruising, hypertension, hyperglycemia/diabetes, osteoporosis, immunosuppression, mood changes. Causes: exogenous glucocorticoid therapy (most common), ACTH-secreting pituitary adenoma (Cushing disease), adrenal adenoma/carcinoma, and ectopic ACTH secretion. Diagnosis: 24-hr urinary free cortisol, late-night salivary cortisol, dexamethasone suppression test; localization by ACTH level and imaging.

Common Symptoms

Central obesity; moon face; buffalo hump; purple striae; proximal weakness; hypertension; hyperglycemia; easy bruising; mood disturbance

Causes and Pathogenesis

Sustained cortisol excess from iatrogenic steroids, pituitary ACTH adenoma, adrenal neoplasm, or ectopic ACTH; cortisol drives central adiposity, protein catabolism, insulin resistance, and hypertension.

Treatment

Treat cause: transsphenoidal surgery for Cushing disease; adrenalectomy for adrenal tumor; resect ectopic source; taper exogenous steroids; steroidogenesis inhibitors (metyrapone, ketoconazole) as bridge

Preventive Measures

Minimize chronic glucocorticoid exposure; screen at-risk patients; manage BP/glucose/bone density.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.