HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Hypercortisolism with characteristic clinical symptoms due to exogenous or endogenous excess supply of glucocorticoids and possibly androgens
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ClassificationThis section has been translated automatically.
- Exogenous Cushing's syndrome (frequent)
- Iatrogenic Cushing's syndrome (through long-term regular, systemic administration of ACTH or glucocorticoids).
- Endogenous Cushing's syndrome (rarely 2-3 cases/1 million inhabitants)
- Central Cushing's Syndrome (Cushing's Disease: 72% of all cases): Increased production of ACTH in the anterior pituitary gland followed by increased corticoid release from the adrenal cortex (see also pituitary diseases, skin changes).
- Adrenal Cushing's Syndrome (about 20% of all cases, 80% of women are affected): increased secretion of gluco- or mineralocorticoids from the adrenal cortex in the course of neoplasia (adrenal cortex adenomas: 50% of cases or adrenal cortex carcinomas: 50% of cases) with subsequent suppressed release of ACTH from the anterior pituitary gland); so-called "white Cushing's" s.a. " white Addison's". In very rare cases of adrenal adenomatosis (<1% of all cases) multiple small andenomas are also detectable.
- Ectopic (paraneoplastic) Cushing's syndrome (formation of corticoids in ectopic tissue, e.g. in small cell bronchial carcinoma).
- Hypothalamic-pituitary Cushing's syndrome (disturbances of the hypothalamic-pituitary regulation).
- Pseudo-Cushing's syndrome, so-called Cushingoid (passagere Cushing's symptoms e.g. after severe cranial injuries).
- Iatrogenic Cushing's syndrome: As a result of long-term therapy with ACTH or glucocorticosteroids.
Clinical featuresThis section has been translated automatically.
Clinical-dermatological symptoms are weight gain with central obesity with the typical full moon face and buffalo neck, striae cutis distensae (abdomen, thighs, axial folds), fatigue, muscle weakness, plethora, arterial hypertension, general poor performance, impotence, oligo to amenorrhea, depressive moods, sleep disorders, anxiety and other personality disorders as well as steroid acne. In 20% of patients (mainly women) there is hypertrichosis to hirsutism. In children there are growth disturbances due to the excess of corticosteroids.
Furthermore, osteoporosis with back pain, as well as loss of potency and libido.
DiagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
LiteratureThis section has been translated automatically.
- Apert E (1910) Dystrophies en relation avec des lésions des capsules surrénales. Hirsutisme et progenia. Bulletin of the Société de pédiatrie de Paris 12: 501-518
- Cushing HW (1932) The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism). Bull Johns Hopkins Hosp 50: 137-195
- Gallais A (1912) Le syndrome génitosurrénal, étude anatomo-clinique. Thesis, Paris, p. 224
- Kolyvanos Naumann U et al (2003) Cushing syndrome/Cushing disease. Switzerland Rundsch Med Prax 92: 1763-1777
- Lacroix A, Bolte E, Tremblay J et al (1992) Gastric inhibitory polypeptide-dependent cortisol hypersecretion - A new cause of Cushing's syndrome. N Engl J Med 327: 974-980
- Magialou MA et al (1994) Cushing's syndrome in children and adolescents. Presentation, Diagnosis and Therapy. N Engl J Med 331: 629-636
- Mönig H, Schulte HM (1992) Ectopic ACTH syndrome. Dtsch med Wschr 117: 1605-1610
- Nieman LK (2002) Medical therapy of Cushing's disease. Pituitary 5: 77-82
- Oldfield EH, Doppman JL, Nieman L et al (1991) Petrosal sinus sampling with and without corticotropin-releasing hormones for the differential diagnosis of Cushing's syndrome. N Engl J Med 325: 897-905
- Orth DN (1992) Corticotropin-releasing hormones in humans. Endocr Rev 13: 164-191
- Pereira AM et al (2003) Long-term predictive value of postsurgical cortisol concentrations for cure and
- risk of recurrence in Cushing's disease. J Clin Endocrinol Metab 88: 5858-5864
- Reznik Y, Allali-Zerah V, Chayvialle JA et al. (1992) Food-dependent Cushing's syndrome mediated by aberrant adrenal sensitivity to gastric inhibitory polypeptides. N Engl J Med 327: 981-986
- Saeger W (2003) Adrenocortical tumours. Pathologist 24: 272-279
Incoming links (31)Adrenal gland, skin changes; Alternariosis cutaneous; Apert-cushing's syndrome; Apert-gallais syndrome; Basophil adenoma; Budesonide; Carney complex; Crooke-apert-gallais syndrome; Cushing purpura; Cushing\'s basophilism; ... Show all
Outgoing links (9)Addison, white; Glucocorticosteroids; Glucocorticosteroids systemic; Hirsutism; Hyperpigmentation; Pituitary gland diseases, skin changes; Purpura (overview); Steroid acne; Striae cutis distensae;
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