Cushing's syndrome; hypercortisolism; hyperadrenocorticism; pluriglandular syndrome

From Aaushi
Jump to navigation Jump to search

Introduction

Endogenous Cushing's syndrome due to increased cortisol by adrenal gland.

Etiology

* ritoavir inhibits CYP3A4 that metabolizes fluticasone (NEJM)[11], replace with beclomethasone (can be used to treat asthma in combination with HIV1 protease inhibitor)

Pathology

Clinical manifestations

* specific findings

# due to androgen excess with adrenal adenoma or adrenal carcinoma[4]

Laboratory

* initial diagnostic tests[4]

* best time for evaluation of patient with suspected Cushing's syndrome in a hospitalized patient is 2 weeks after hospital discharge & recovery from stress of hospitalization

Radiology

Complications

Differential diagnosis

Management

Notes

More general terms

More specific terms

Additional terms

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1960-1
  2. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 475-76
  3. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 225-27
  4. 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2022.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  5. 5.0 5.1 ARUP: http://www.aruplab.com/guides/ug/tests/0000000.jsp https://ltd.aruplab.com/Tests/Pub/0070010
    ARUP Consult: Adrenal Hyperfunction - Cushing Syndrome The Physician's Guide to Laboratory Test Selection &nInterpretation https://www.arupconsult.com/content/adrenal-hyperfunction
    ARUP Consult: Adrenal Hyperfunction (Cushing Syndrome) Testing Algorithm https://arupconsult.com/algorithm/adrenal-hyperfunction-cushing-syndrome-testing-algorithm
  6. 6.0 6.1 Fardet L et al Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing's syndrome: cohort study BMJ 2012;345:e4928 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22846415 <Internet> http://www.bmj.com/content/345/bmj.e4928
  7. Nieman LK, Biller BM, Findling JW et al The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008 May;93(5):1526-40 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18334580
  8. Colao A, Petersenn S, Newell-Price J et al A 12-month phase 3 study of pasireotide in Cushing's disease. N Engl J Med. 2012 Mar 8;366(10):914-24. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22397653 Free Article
  9. Di Dalmazi G, Berr CM, Fassnacht M et al Adrenal function after adrenalectomy for subclinical hypercortisolism and Cushing's syndrome: a systematic review of the literature. J Clin Endocrinol Metab. 2014 Aug;99(8):2637-45. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24878052
  10. 10.0 10.1 Loriaux DL Diagnosis and Differential Diagnosis of Cushing's Syndrome. N Engl J Med 2017; 376:1451-1459. April 13, 2017 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28402781 https://www.nejm.org/doi/pdf/10.1056/NEJMra1505550
  11. 11.0 11.1 11.2 11.3 11.4 NEJM Knowledge+ Endocrinology
  12. NINDS Cushing's Syndrome Information Page https://www.ninds.nih.gov/disorders/all-disorders/cushings-syndrome-information-page
    NIDDK: Cushing's Syndrome http://www.niddk.nih.gov/health/endo/pubs/cushings/cushings.htm
    National Institute of Child Health & Human Development Cushing's Syndrome http://www.nichd.nih.gov/publications/pubs/cushings.htm

Patient information

Cushing's Syndrome patient information

Database