950:
1042:
331:
54:
339:
354:
1025:
is a powerful glucocorticoid type II receptor antagonist and, since it does not interfere with normal cortisol homeostasis type I receptor transmission, may be especially useful for treating the cognitive effects of
Cushing's syndrome. However, the medication faces considerable controversy due to its
984:
Urinary cortisol levels directly reflect circulating free cortisol. Excess cortisol saturates binding proteins and is eliminated in urine as free cortisol, making it a helpful diagnostic for hypercortisolemia. Values four times higher than the top range of normal are uncommon, especially in
Cushing's
1065:
Removal of the adrenals in the absence of a known tumor is occasionally performed to eliminate the production of excess cortisol. In some occasions, this removes negative feedback from a previously occult pituitary adenoma, which starts growing rapidly and produces extreme levels of ACTH, leading to
881:
and simulates the effects of cortisol, including negative feedback on the pituitary gland. When dexamethasone is administered and a blood sample is tested, cortisol levels >50 nmol/L (1.81 μg/dL) would be indicative of
Cushing's syndrome because an ectopic source of cortisol or ACTH (such as
687:
to produce high levels of cortisol, producing the disease state. While all
Cushing's disease gives Cushing's syndrome, not all Cushing's syndrome is due to Cushing's disease. Several possible causes of Cushing's syndrome are known including the taking of herbal supplements over-the-counter that do
675:
Cushing's syndrome may result from any cause of increased glucocorticoid levels, whether due to medication or internal processes. Some sources however do not consider the glucocorticoid medication-induced condition as "Cushing's syndrome" proper, instead using the term "Cushingoid" to describe the
993:
Most cases of
Cushingoid symptoms are caused by corticosteroid medications, such as those used for asthma, arthritis, eczema and other inflammatory conditions. Consequently, most patients are effectively treated by carefully tapering off (and eventually stopping) the medication that causes the
844:
means a group of symptoms). One of the causes of
Cushing's syndrome is a cortisol-secreting adenoma in the cortex of the adrenal gland (primary hypercortisolism/hypercorticism). The adenoma causes cortisol levels in the blood to be very high, and negative feedback on the pituitary from the high
317:
About two to three cases per million persons are caused overtly by a tumor. It most commonly affects people who are 20 to 50 years of age. Women are affected three times more often than men. A mild degree of overproduction of cortisol without obvious symptoms, however, is more common. Cushing's
933:
sampling) is necessary. In many cases, the tumors causing
Cushing's disease are less than 2 mm in size and difficult to detect using MRI or CT imaging. In one study of 261 patients with confirmed pituitary Cushing's disease, only 48% of pituitary lesions were identified using MRI prior to
3329:
Arnaldi, G.; Angeli, A.; Atkinson, A. B.; Bertagna, X.; Cavagnini, F.; Chrousos, G. P.; Fava, G. A.; Findling, J. W.; Gaillard, R. C.; Grossman, A. B.; Kola, B.; Lacroix, A.; Mancini, T.; Mantero, F.; Newell-Price, J.; Nieman, L. K.; Sonino, N.; Vance, M. L.; Giustina, A.; Boscaro, M. (2003).
1001:
should be removed after diagnosis. Regardless of the adenoma's location, most patients require steroid replacement postoperatively at least in the interim, as long-term suppression of pituitary ACTH and normal adrenal tissue does not recover immediately. Clearly, if both adrenals are removed,
1034:) in adult patients who are not candidates for surgery, or who did not respond to prior surgery, with the warning that mifepristone should never be used by pregnant women- although pregnancy is extremely rare during the course of Cushing's Syndrome In March 2020, Isturisa (
666:
When
Cushing's syndrome is caused by an increase of cortisol at the level of the adrenal glands (via an adenoma or hyperplasia), negative feedback ultimately reduces ACTH production in the pituitary. In these cases, ACTH levels remain low and no hyperpigmentation develops.
720:. In exogenous Cushing's, the adrenal glands may often gradually atrophy due to lack of stimulation by ACTH, the production of which is suppressed by glucocorticoid medication. Abruptly stopping the medication can thus result in acute and potentially life-threatening
1082:
is the most common form. Cushing's disease is rare; a Danish study found an incidence of less than one case per million people per year. However, asymptomatic microadenomas (less than 10 mm in size) of the pituitary are found in about one in six individuals.
724:
and the dose must hence be slowly and carefully tapered off to allow internal cortisol production to pick up. In some cases, patients never recover sufficient levels of internal production and must continue taking glucocorticoids at physiological doses for life.
859:) (tertiary hypercortisolism/hypercorticism). This causes the blood ACTH levels to be elevated along with cortisol from the adrenal gland. The ACTH levels remain high because the tumor is unresponsive to negative feedback from high cortisol levels.
314:. If the pituitary was affected, other medications may be required to replace its lost function. With treatment, life expectancy is usually normal. Some, in whom surgery is unable to remove the entire tumor, have an increased risk of death.
270:, which is the second most common cause of Cushing's syndrome after medication. A number of other tumors, often referred to as ectopic due to their placement outside the pituitary, may also cause Cushing's. Some of these are associated with
977:
The 24-hour urine-free cortisol test, the low-dose dexamethasone suppression test, and the measurement of midnight plasma cortisol or late-night salivary cortisol are the three primary tests used to diagnose
Cushing's syndrome.
561:
Brain changes such as cerebral atrophy may occur. This atrophy is associated with areas of high glucocorticoid receptor concentrations such as the hippocampus and correlates highly with psychopathological personality changes.
2517:
Lynnette K. Nieman, Beverly M. K. Biller, James W. Findling, John Newell-Price, Martin O. Savage, Paul M. Stewart, Victor M. Montori, The
Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline,
4190:
3557:
796:
and thereby cause the total cortisol level to be elevated. However, the total free cortisol, which is the active hormone in the body, as measured by a 24-hour urine collection for urinary free cortisol, is normal.
3896:
3881:
3866:
1038:) oral tablets a 11-beta-hydroxylase enzyme inhibitor was approved by FDA for treating those patients who cannot undergo pituitary surgery or for patients who underwent surgery but continue to have the disease.
967:*There is consensus that all patients with lesions smaller than 6 mm in diameter should have IPSS and those with lesions of ≥10 mm do not need IPSS, but expert opinions differed for lesions 6–9 mm in diameter.
393:(the weight gain in Cushing's syndrome stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs, or breasts, proximal muscle weakness (hips, shoulders), and
2832:
Schteingart DE, Lloyd RV, Akil H, Chandler WF, Ibarra-Perez G, Rosen SG, Ogletree R (September 1986). "Cushing's syndrome secondary to ectopic corticotropin-releasing hormone-adrenocorticotropin secretion".
467:
Cognitive conditions, including memory and attention dysfunctions, as well as depression, are commonly associated with elevated cortisol, and may be early indicators of exogenous or endogenous Cushing's.
305:
Most cases can be treated and cured. If due to medications, these can often be slowly decreased if still required or slowly stopped. If caused by a tumor, it may be treated by a combination of surgery,
716:
after organ transplants. Administration of synthetic ACTH is also possible, but ACTH is less often prescribed due to cost and lesser utility. Rarely, Cushing's syndrome can also be due to the use of
558:
is also an issue in Cushing's syndrome since osteoblast activity is inhibited. Additionally, Cushing's syndrome may cause sore and aching joints, particularly in the hip, shoulders, and lower back.
886:
over 24 hours, which may be equally sensitive, as late-night levels of salivary cortisol are high in cushingoid patients. Other pituitary hormone levels may need to be ascertained. Performing a
4223:
4200:
4067:
4195:
4162:
4125:
877:(administration of dexamethasone and frequent determination of cortisol and ACTH level), or a 24-hour urinary measurement for cortisol offers equal detection rates. Dexamethasone is a
2136:"MECHANISMS IN ENDOCRINOLOGY: Cushing's syndrome causes irreversible effects on the human brain: a systematic review of structural and functional magnetic resonance imaging studies"
4205:
4157:
4120:
3561:
3465:
Caimari F, Valassi E, Garbayo P, Steffensen C, Santos A, Corcoy R, Webb SM (February 2017). "Cushing's syndrome and pregnancy outcomes: a systematic review of published cases".
981:
Hypercortisolism is related with routine chemistry abnormalities such as neutrophilic leucocytosis, hyperglycemia, hypokalaemia, hypercholesterolemia, and hypercoagulability.
3600:
Aggarwal S, Yadav K, Sharma AP, Sethi V (June 2013). "Laparoscopic bilateral transperitoneal adrenalectomy for Cushing syndrome: surgical challenges and lessons learnt".
1885:
4335:
3772:
Van Zaane B, Nur E, Squizzato A, Dekkers OM, Twickler MT, Fliers E, et al. (August 2009). "Hypercoagulable state in Cushing's syndrome: a systematic review".
929:
scan is occasionally necessary. Occasionally, determining the ACTH levels in various veins in the body by venous catheterization, working towards the pituitary (
1345:
788:
Elevated levels of total cortisol can also be due to estrogen found in oral contraceptive pills that contain a mixture of estrogen and progesterone, leading to
765:
Tumors outside the normal pituitary-adrenal system can produce ACTH (occasionally with CRH) that affects the adrenal glands. This etiology is called ectopic or
1312:
1212:
1789:
1624:
437:. Studies have also shown that the resultant amenorrhea is due to hypercortisolism, which feeds back onto the hypothalamus resulting in decreased levels of
1709:
Graversen D, Vestergaard P, Stochholm K, Gravholt CH, Jørgensen JO (April 2012). "Mortality in Cushing's syndrome: a systematic review and meta-analysis".
762:
In adrenal Cushing's, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia.
282:. Diagnosis requires a number of steps. The first step is to check the medications a person takes. The second step is to measure levels of cortisol in the
1409:
1376:
4305:
4591:
2533:
3996:
3148:
2868:
Voyadzis JM, Guttman-Bauman I, Santi M, Cogen P (February 2004). "Hypothalamic hamartoma secreting corticotropin-releasing hormone. Case report".
937:
Plasma CRH levels are inadequate at diagnosis (with the possible exception of tumors secreting CRH) because of peripheral dilution and binding to
123:
High blood pressure (hypertension), Type 2 diabetes, Frequent or unusual infections, Loss of muscle mass and strength, Bone loss (osteoporosis).
4586:
882:
adrenal adenoma) exists which is not inhibited by the dexamethasone. A novel approach, recently cleared by the US FDA, is sampling cortisol in
554:
disturbances, opportunistic infections, and impaired wound healing related to cortisol's suppression of the immune and inflammatory responses.
1959:"Menstrual abnormalities in women with Cushing's disease are correlated with hypercortisolemia rather than raised circulating androgen levels"
663:. A variant of Cushing's disease can be caused by ectopic, i.e. extra pituitary, ACTH production from, for example, a small-cell lung cancer.
479:
Other striking and distressing skin changes that may appear in Cushing's syndrome include facial acne, susceptibility to superficial fungus (
2275:
Wolkowitz OM, Lupien SJ, Bigler ED (June 2007). "The "steroid dementia syndrome": a possible model of human glucocorticoid neurotoxicity".
1271:
651:
production as a byproduct of ACTH synthesis from pro-opiomelanocortin (POMC). Alternatively, it is proposed that the high levels of ACTH,
3576:
1828:
1448:
4057:
3373:
Belanoff JK, Flores BH, Kalezhan M, Sund B, Schatzberg AF (October 2001). "Rapid reversal of psychotic depression using mifepristone".
2784:
1013:
In those patients not suited for or unwilling to undergo surgery, several drugs have been found to inhibit cortisol synthesis (e.g.
779:
Finally, rare cases of CRH-secreting tumors (without ACTH secretion) have been reported, which stimulates pituitary ACTH production.
1685:
2962:
4050:
4505:
4386:
4298:
3643:
Nelson DH, Meakin JW, Thorn GW (March 1960). "ACTH-producing pituitary tumors following adrenalectomy for Cushing's syndrome".
1234:
1877:
4416:
4185:
3080:
2093:
1127:
389:, thinning of the skin (which causes easy bruising and dryness, particularly the hands) and mucous membranes, purple or red
4368:
4268:
3989:
1122:
679:
Cushing's disease is a specific type of Cushing's syndrome caused by a pituitary tumor leading to excessive production of
4228:
969:†This alternative option does not have clear consensus and needs further research, and this is indicated by darker boxes.
275:
4363:
298:. If this test is abnormal, the cortisol may be measured late at night. If the cortisol remains high, a blood test for
27:
3286:
Yanovski, Jack A.; Cutler, Gordon B. (1994). "Glucocorticoid Action and the Clinical Features of Cushing's Syndrome".
4291:
2118:
1822:
1442:
1341:
1308:
4581:
4256:
1208:
1785:
4546:
4515:
4510:
4421:
3982:
2552:
1957:
Lado-Abeal J, Rodriguez-Arnao J, Newell-Price JD, Perry LA, Grossman AB, Besser GM, Trainer PJ (September 1998).
1620:
1564:
856:
814:
2608:
Siminoski K, Goss P, Drucker DJ (November 1989). "The Cushing syndrome induced by medroxyprogesterone acetate".
4340:
4180:
1405:
1372:
874:
648:
295:
728:
Cushing's syndrome in childhood is especially rare and usually results from use of glucocorticoid medication.
357:
Features of Cushing syndrome including a round face, acne, reddish skin, central obesity, and poor muscle tone
4477:
1516:"Facial Plethora: Modern Technology for Quantifying an Ancient Clinical Sign and Its Use in Cushing Syndrome"
4431:
4102:
4095:
4013:
3165:
Newell-Price, John; Bertagna, Xavier; Grossman, Ashley B; Nieman, Lynnette K (2006). "Cushing's syndrome".
837:
on CRH in the hypothalamus, which decreases the amount of ACTH released from the anterior pituitary gland.
789:
739:
Cushing's syndrome results from some derangement of the body's own system of cortisol secretion. Normally,
551:
2318:
Weber S, Habel U, Amunts K, Schneider F (2008). "Structural brain abnormalities in psychopaths-a review".
3022:
Jagannathan J, Smith R, DeVroom HL, Vortmeyer AO, Stratakis CA, Nieman LK, Oldfield EH (September 2009).
2228:"Examining the effect of psychopathic traits on gray matter volume in a community substance abuse sample"
2134:
Andela CD, van Haalen FM, Ragnarsson O, Papakokkinou E, Johannsson G, Santos A, et al. (July 2015).
949:
717:
212:
2422:"Recovery of Adrenal Function in Patients with Glucocorticoids Induced Secondary Adrenal Insufficiency"
2187:"The longitudinal course of psychopathology in Cushing's syndrome after correction of hypercortisolism"
3098:
3678:
Lindholm J, Juul S, Jørgensen JO, Astrup J, Bjerre P, Feldt-Rasmussen U, et al. (January 2001).
997:
If an adrenal adenoma is identified, it may be removed by surgery. An ACTH-secreting corticotrophic
4556:
3911:
2226:
Cope LM, Shane MS, Segall JM, Nyalakanti PK, Stevens MC, Pearlson GD, et al. (November 2012).
1274:. National Endocrine and Metabolic Diseases Information Service (NEMDIS). July 2008. Archived from
4520:
4487:
4472:
4444:
4314:
4072:
3200:
Boscaro, Marco; Barzon, Luisa; Fallo, Francesco; Sonino, Nicoletta (2001). "Cushing's syndrome".
1059:§Lifelong monitoring for hypopituitarism and secondary neoplasia in the radiation field required.
930:
867:
660:
118:
2979:
Raff H, Findling JW (June 2003). "A physiologic approach to diagnosis of the Cushing syndrome".
985:
disease. A single measurement lacks sensitivity for people with intermittent hypercortisolemia.
704:
Cushing's syndrome). Glucocorticoids are used in treatment of a variety of disorders, including
4005:
1275:
236:
3940:
3875:
2781:
1812:
1432:
1041:
322:
in 1932. Cushing's syndrome may also occur in other animals including cats, dogs, and horses.
4238:
4035:
3142:
2992:
1116:
899:
855:(secondary hypercortisolism/hypercorticism) or due to excess production of hypothalamus CRH (
721:
3099:
Fleseriu M, Auchus R, Bancos I, Ben-Shlomo A, Bertherat J, Biermasz NR; et al. (2021).
2086:
The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences
1090:. Other factors such as surgery and obesity also increase the chance of getting thrombosis.
4551:
4500:
4495:
4355:
4263:
4062:
2916:
2861:
2791:
at The National Endocrine and Metabolic Diseases Information Service. July 2008. Citing: *
1111:
1067:
887:
851:
refers only to hypercortisolism secondary to excess production of ACTH from a corticotroph
848:
770:
756:
709:
628:
519:
267:
3024:"Outcome of using the histological pseudocapsule as a surgical capsule in Cushing disease"
550:(increased Na+ ions concentration in plasma). Furthermore, excessive cortisol may lead to
8:
4411:
4396:
3951:
3900:
469:
2959:
2920:
821:). ACTH travels via the blood to the adrenal gland, where it stimulates the release of
755:
In pituitary Cushing's, a benign pituitary adenoma secretes ACTH. This is also known as
4525:
4454:
4030:
3808:
3754:
3625:
3539:
3510:"Cushing's syndrome during pregnancy: personal experience and review of the literature"
3490:
3442:
3417:
3398:
3125:
3100:
3048:
3023:
3004:
2937:
2904:
2759:
2734:
2669:
2644:
2585:
2495:
2470:
2446:
2421:
2356:
2300:
2252:
2227:
1934:
1907:
1597:
1540:
1515:
1491:
1466:
1178:
1151:
507:
449:
445:
81:
20:
3905:
3558:"FDA approves mifepristone (Korlym*) for patients with endogenous Cushing' s syndrome"
3299:
3213:
3178:
3116:
2243:
2062:
2049:
Belanoff JK, Gross K, Yager A, Schatzberg AF (2001). "Corticosteroids and cognition".
1855:
1030:. In February 2012, the FDA approved mifepristone to control high blood sugar levels (
405:. The excess cortisol may also affect other endocrine systems and cause, for example,
4391:
4152:
3789:
3746:
3720:
3701:
3660:
3617:
3531:
3482:
3447:
3390:
3386:
3355:
3347:
3311:
3303:
3268:
3260:
3256:
3225:
3217:
3182:
3130:
3076:
3053:
2996:
2942:
2885:
2850:
2814:
2764:
2715:
2674:
2625:
2590:
2572:
2500:
2451:
2393:
2335:
2292:
2257:
2208:
2167:
2114:
2089:
2066:
2031:
1998:
Arnaldi G, Scandali VM, Trementino L, Cardinaletti M, Appolloni G, Boscaro M (2010).
1980:
1939:
1859:
1818:
1767:
1726:
1667:
1602:
1584:
1545:
1496:
1438:
1183:
1087:
998:
852:
834:
713:
644:
583:
539:
515:
473:
311:
263:
244:
200:
147:
90:
69:
3758:
3629:
3543:
3494:
3008:
2304:
4322:
4045:
3781:
3736:
3691:
3652:
3609:
3521:
3474:
3437:
3429:
3402:
3382:
3339:
3322:
3295:
3252:
3243:
Kaye, Todd B. (1990-03-15). "The Cushing Syndrome: An Update on Diagnostic Tests".
3209:
3174:
3120:
3112:
3043:
3035:
2988:
2932:
2924:
2877:
2842:
2806:
2754:
2746:
2705:
2694:"Adrenal Insufficiency in Corticosteroids Use: Systematic Review and Meta-Analysis"
2664:
2656:
2617:
2580:
2564:
2490:
2482:
2441:
2433:
2327:
2284:
2247:
2239:
2198:
2157:
2147:
2058:
2021:
2011:
1970:
1929:
1919:
1851:
1757:
1718:
1659:
1592:
1576:
1535:
1527:
1486:
1478:
1173:
1163:
1057:‡See table 2 and panel 3 for considerations regarding selection of medical therapy.
894:
defect may be necessary if a pituitary lesion is suspected, which may compress the
830:
813:
sits just below it. The paraventricular nucleus (PVN) of the hypothalamus releases
250:
Cushing's syndrome is caused by either excessive cortisol-like medication, such as
4439:
3916:
3613:
2966:
2810:
2788:
1663:
926:
914:
810:
744:
366:
220:
188:
106:
3962:
3837:
3101:"Consensus on diagnosis and management of Cushing's disease: a guideline update"
2881:
2621:
2185:
Dorn LD, Burgess ES, Friedman TC, Dubbert B, Gold PW, Chrousos GP (March 1997).
1437:(2nd ed.). Baltimore, Md.: Lippincott Williams & Wilkins. p. 167.
652:
330:
4330:
4246:
3656:
3433:
2660:
2568:
2385:
1722:
1580:
1079:
1003:
878:
697:
684:
487:) infections, and the characteristic purplish, atrophic striae on the abdomen.
426:
386:
319:
279:
258:
that either produces or results in the production of excessive cortisol by the
3680:"Incidence and late prognosis of cushing's syndrome: a population-based study"
3478:
2750:
2437:
2288:
1482:
1152:"Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs"
4575:
4040:
3351:
3307:
3264:
3221:
3186:
2576:
1588:
1031:
1027:
918:
917:
are performed to detect the presence of any adrenal or pituitary adenomas or
826:
766:
748:
547:
531:
511:
390:
382:
374:
259:
216:
102:
74:
26:
This article is about the disease in humans. For the disease in animals, see
3890:
3418:"Desmopressin Stimulation Test in a Pregnant Patient with Cushing's Disease"
3330:"Diagnosis and Complications of Cushing's Syndrome: A Consensus Statement".
3039:
2969:
at A.D.A.M. Medical Encyclopedia, PubMedHealth, National Institute of Health
1086:
About 0.9 to 1% of those with Cushing's syndrome have a tendency to develop
817:(CRH), which stimulates the pituitary gland to release adrenocorticotropin (
4406:
4283:
3793:
3750:
3705:
3696:
3679:
3664:
3621:
3535:
3486:
3451:
3394:
3359:
3343:
3229:
3134:
3057:
3000:
2889:
2818:
2768:
2719:
2594:
2504:
2455:
2397:
2339:
2296:
2261:
2203:
2186:
2171:
2070:
2035:
1975:
1958:
1943:
1863:
1771:
1730:
1671:
1606:
1549:
1500:
1187:
1168:
1035:
1022:
1014:
1007:
922:
895:
891:
840:
Strictly, Cushing's syndrome refers to excess cortisol of any etiology (as
806:
701:
588:
578:
555:
542:
activity in high concentrations, worsening the hypertension and leading to
510:(especially common with ACTH production outside the pituitary), leading to
499:
480:
461:
453:
402:
307:
224:
204:
196:
94:
86:
3315:
3272:
2946:
2928:
2854:
2846:
2678:
2629:
2212:
1984:
1956:
1924:
401:
and/or extremely dry and brittle hair. In rare cases, Cushing's can cause
4530:
4251:
4112:
4022:
3974:
3935:
3785:
3526:
3509:
2710:
2693:
2471:"Cushing's syndrome: update on signs, symptoms and biochemical screening"
1881:
1531:
1099:
793:
773:
606:
543:
503:
430:
422:
98:
2486:
2152:
2135:
2026:
4401:
3957:
3741:
3724:
3415:
2162:
1018:
656:
600:
495:
484:
271:
251:
3858:
2133:
2016:
1999:
1908:"Cushing Syndrome in a 6-Month-Old Infant due to Adrenocortical Tumor"
1762:
1745:
4378:
3946:
1997:
1708:
696:
The most common cause of Cushing's syndrome is the use of prescribed
618:
612:
434:
418:
410:
394:
378:
342:
232:
208:
165:
61:
2794:
2331:
1647:
1406:"How many people are affected by or at risk for Cushing's syndrome?"
178:
2–3 per million people per year (from 1/333,333 to 1/500,000 people)
16:
Symptoms from excessive exposure to glucocorticoids such as cortisol
4464:
4082:
2551:
Patel, Reema; Sherf, Sahar; Lai, Ngan Betty; Yu, Run (2022-11-01).
1563:
Patel, Reema; Sherf, Sahar; Lai, Ngan Betty; Yu, Run (2022-11-01).
841:
822:
736:
623:
527:
491:
406:
398:
370:
240:
192:
187:
is a collection of signs and symptoms due to prolonged exposure to
140:
3164:
2534:"Public Notification: Artri King contains hidden drug ingredients"
349:
in a 30 year old female patient with iatrogenic Cushing's syndrome
64:
of a 30 year old female patient with iatrogenic Cushing's syndrome
3416:
Parksook WW, Porntharukchareon T, Sunthornyothin S (2022-05-30).
1053:*Pituitary surgery should be performed by an experienced surgeon.
906:
457:
362:
3021:
2867:
676:
medication's side effects which mimic the endogenous condition.
365:, particularly of the trunk and face with sparing of the limbs (
47:
Hypercortisolism, Itsenko-Cushing syndrome, hyperadrenocorticism
3885:
3870:
3464:
2692:
Broersen LH, Pereira AM, Jørgensen JO, Dekkers OM (June 2015).
2691:
1102:
announced that she had been diagnosed with Cushing's syndrome.
883:
866:
it is known as ectopic Cushing syndrome. This may be seen in a
705:
523:
414:
338:
287:
53:
3577:"FDA Approves New Treatment for Adults with Cushing's Disease"
1905:
353:
3602:
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
3507:
3328:
938:
747:
when necessary to stimulate the release of cortisol from the
683:(adrenocorticotropic hormone). Excessive ACTH stimulates the
535:
518:. Insulin resistance is accompanied by skin changes such as
346:
291:
283:
255:
3771:
3723:, Barr CE, Dodge WE, Vance ML, McCutcheon IE (August 2004).
2831:
2553:"Exogenous Cushing Syndrome Caused by a "Herbal" Supplement"
2048:
1743:
1565:"Exogenous Cushing Syndrome Caused by a "Herbal" Supplement"
1467:"Cushing's syndrome: all variants, detection, and treatment"
759:
and is responsible for 70% of endogenous Cushing's syndrome.
3725:"The prevalence of pituitary adenomas: a systematic review"
3677:
3508:
Lindsay JR, Jonklaas J, Oldfield EH, Nieman LK (May 2005).
1309:"How do health care providers diagnose Cushing's syndrome?"
1149:
863:
818:
740:
680:
640:
438:
299:
228:
110:
3574:
3372:
2184:
1686:"Cushing syndrome - Diagnosis and treatment - Mayo Clinic"
3809:"Amy Schumer: Actress reveals she has Cushing's Syndrome"
2317:
2225:
1513:
1150:
Celik O, Niyazoglu M, Soylu H, Kadioglu P (August 2012).
910:
369:). Common signs include the growth of fat pads along the
3599:
3199:
2420:
Baek JH, Kim SK, Jung JH, Hahm JR, Jung J (March 2016).
1906:
Fudge EB, von Allmen D, Volmar KE, Calikoglu AS (2009).
1844:
The Veterinary Clinics of North America. Equine Practice
1514:
Afshari, A; Ardeshirpour, Y; Lodish, MB (October 2015).
530:
in the axilla. Untreated Cushing's syndrome can lead to
2532:
Research, Center for Drug Evaluation and (2022-10-31).
2000:"Pathophysiology of dyslipidemia in Cushing's syndrome"
1066:
hyperpigmentation. This clinical situation is known as
973:
Darker colors indicate less validated testing pathways.
833:
in response to ACTH. Elevated levels of cortisol exert
3332:
The Journal of Clinical Endocrinology & Metabolism
2520:
The Journal of Clinical Endocrinology & Metabolism
1842:
McCue PM (December 2002). "Equine Cushing's disease".
1744:
Steffensen C, Bak AM, Rubeck KZ, Jørgensen JO (2010).
318:
syndrome was first described by American neurosurgeon
3718:
3288:
Endocrinology and Metabolism Clinics of North America
3279:
2739:
Endocrinology and Metabolism Clinics of North America
2274:
1817:(3 ed.). Elsevier Health Sciences. p. 502.
1471:
Endocrinology and Metabolism Clinics of North America
953:
Diagnostic algorithm of suspected Cushing's syndrome:
231:, and fragile skin that heals poorly. Women may have
3848:
3774:
The Journal of Clinical Endocrinology and Metabolism
3684:
The Journal of Clinical Endocrinology and Metabolism
3514:
The Journal of Clinical Endocrinology and Metabolism
2835:
The Journal of Clinical Endocrinology and Metabolism
2698:
The Journal of Clinical Endocrinology and Metabolism
2607:
2191:
The Journal of Clinical Endocrinology and Metabolism
1963:
The Journal of Clinical Endocrinology and Metabolism
1520:
The Journal of Clinical Endocrinology and Metabolism
444:
Many of the features of Cushing's are those seen in
2645:"Cushing's syndrome induced by medroxyprogesterone"
2268:
2111:
Andrews' Diseases of the Skin: Clinical Dermatology
845:cortisol levels causes ACTH levels to be very low.
2522:, Volume 93, Issue 5, 1 May 2008, Pages 1526–1540,
769:Cushing's disease and is seen in diseases such as
659:, which contain weak MSH function, can act on the
23:, which is due to increased intracranial pressure.
3642:
2108:
1342:"What are the treatments for Cushing's syndrome?"
4573:
3236:
2795:"Evaluation and treatment of Cushing's syndrome"
2379:
2377:
1912:International Journal of Pediatric Endocrinology
1648:"Evaluation and treatment of Cushing's syndrome"
921:(the incidental discovery of harmless lesions).
3094:
3092:
2775:
2642:
2550:
2419:
2178:
2088:(5th ed.). American Psychiatric Pub, Inc.
1562:
1093:
873:When Cushing's syndrome is suspected, either a
688:not list glucocorticoids in their ingredients.
3285:
3251:(6). American College of Physicians: 434–444.
3160:
3158:
2311:
1209:"What are the symptoms of Cushing's syndrome?"
4299:
3990:
2383:
2374:
2219:
2083:
1303:
1301:
1299:
1297:
1295:
1293:
373:, on the back of the neck ("buffalo hump" or
239:. Occasionally there may be changes in mood,
4313:
3765:
3712:
3671:
3636:
3147:: CS1 maint: multiple names: authors list (
3089:
2978:
2972:
2726:
1991:
1810:
1613:
1464:
1400:
1398:
1396:
1394:
1336:
1334:
1332:
1330:
1203:
1201:
1199:
1197:
1078:Cushing's syndrome caused by treatment with
825:. Cortisol is secreted by the cortex of the
783:
3193:
3155:
2825:
2792:
2601:
1950:
1645:
1460:
1458:
1367:
1365:
1363:
4306:
4292:
4004:
3997:
3983:
1814:Clinical Veterinary Advisor: Dogs and Cats
1290:
1045:Management algorithm of Cushing's disease:
52:
3740:
3695:
3575:Office of the Commissioner (2020-03-24).
3525:
3441:
3124:
3047:
2936:
2758:
2732:
2709:
2668:
2584:
2494:
2445:
2251:
2202:
2161:
2151:
2025:
2015:
1974:
1933:
1923:
1786:"Cushing Syndrome: Condition Information"
1761:
1596:
1539:
1490:
1391:
1373:"Is there a cure for Cushing's syndrome?"
1327:
1266:
1264:
1262:
1260:
1258:
1256:
1194:
1177:
1167:
1145:
1143:
514:and insulin resistance which can lead to
101:, often reddened due to facial plethora,
4592:Syndromes affecting the endocrine system
3338:(12). The Endocrine Society: 5593–5602.
3075:. Boston: Kluwer Academic. p. 115.
2993:10.7326/0003-4819-138-12-200306170-00010
2531:
1678:
1455:
1360:
1040:
948:
862:When Cushing's syndrome is due to extra
352:
337:
329:
4051:Glucocorticoid remediable aldosteronism
3070:
2643:Merrin PK, Alexander WD (August 1990).
2351:
2349:
2102:
1507:
1061:¶On maximum tolerated dose of the drug.
971:Green boxes indicate points to consider
546:(common in ectopic ACTH secretion) and
4574:
4506:Acrokeratosis paraneoplastica of Bazex
4387:Paraneoplastic cerebellar degeneration
3806:
3375:Journal of Clinical Psychopharmacology
2468:
1430:
1253:
1156:Multidisciplinary Respiratory Medicine
1140:
1049:IPSS=inferior petrosal sinus sampling.
963:IPSS=inferior petrosal sinus sampling.
569:Moodiness, irritability, or depression
4587:Medical conditions related to obesity
4287:
3978:
2415:
2413:
1841:
1711:European Journal of Internal Medicine
1128:pituitary pars intermedia dysfunction
905:When any of these tests is positive,
325:
203:but with thin arms and legs, reddish
4369:Nonbacterial thrombotic endocarditis
3844:. U.S. National Library of Medicine.
3242:
2902:
2793:Nieman LK, Ilias I (December 2005).
2361:The Lecturio Medical Concept Library
2346:
2109:James W, Berger T, Elston D (2005).
1746:"Epidemiology of Cushing's syndrome"
1646:Nieman LK, Ilias I (December 2005).
1123:Corticosteroid-induced lipodystrophy
1021:) but they are of limited efficacy.
959:CRH=corticotropin-releasing hormone.
957:CBG=corticosteroid-binding globulin.
792:. Estrogen can cause an increase of
634:
4229:Inborn errors of steroid metabolism
3807:Bushby, Helen (February 26, 2024).
3560:. February 18, 2012. Archived from
1047:DST=dexamethasone suppression test.
961:DST=dexamethasone suppression test.
397:(facial male-pattern hair growth),
276:multiple endocrine neoplasia type 1
13:
4364:Multicentric reticulohistiocytosis
2410:
1465:Sharma ST, Nieman LK (June 2011).
1379:from the original on 27 March 2015
1055:†Absence of ACTH-staining adenoma.
800:
502:(due to cortisol's enhancement of
14:
4603:
4417:Lambert–Eaton myasthenic syndrome
3830:
2475:European Journal of Endocrinology
2320:Behavioral Sciences & the Law
2244:10.1016/j.pscychresns.2012.10.004
2140:European Journal of Endocrinology
1888:from the original on May 25, 2015
1792:from the original on 2 April 2015
1627:from the original on 2 April 2015
1621:"What causes Cushing's syndrome?"
1412:from the original on 2 April 2015
1348:from the original on 2 April 2015
1315:from the original on 2 April 2015
1215:from the original on 2 April 2015
1051:ACTH=adrenocorticotropic hormone.
955:ACTH=adrenocorticotropic hormone.
639:Cushing's syndrome due to excess
195:. Signs and symptoms may include
93:with thin arms and legs, reddish
4269:Waterhouse–Friderichsen syndrome
3387:10.1097/00004714-200110000-00009
3257:10.7326/0003-4819-76-3-112-6-434
3173:(9522). Elsevier BV: 1605–1617.
2799:The American Journal of Medicine
2735:"Cushing syndrome in pediatrics"
1831:from the original on 2017-09-08.
1652:The American Journal of Medicine
1451:from the original on 2017-09-08.
575:Memory and attention dysfunction
526:and around the neck, as well as
506:'s vasoconstrictive effect) and
4547:Febrile neutrophilic dermatosis
4516:Florid cutaneous papillomatosis
4422:Anti-NMDA receptor encephalitis
3800:
3593:
3568:
3550:
3501:
3458:
3409:
3366:
3064:
3015:
2953:
2896:
2876:(2 Suppl Pediatrics): 212–216.
2685:
2636:
2544:
2525:
2511:
2462:
2127:
2077:
2051:Journal of Psychiatric Research
2042:
1899:
1870:
1835:
1804:
1778:
1737:
1702:
1639:
1556:
1073:
857:Corticotropin releasing hormone
815:corticotropin-releasing hormone
460:, and elevated blood levels of
28:Cushing's syndrome (veterinary)
3208:(9258). Elsevier BV: 783–791.
2733:Stratakis CA (December 2012).
2084:Yudofsky SC, Hales RE (2007).
1424:
1227:
875:dexamethasone suppression test
649:melanocyte-stimulating hormone
433:in women due to elevations in
334:Symptoms of Cushing's syndrome
217:fat lump between the shoulders
103:fat lump between the shoulders
1:
4478:Necrolytic migratory erythema
3300:10.1016/s0889-8529(18)30080-x
3214:10.1016/s0140-6736(00)04172-6
3179:10.1016/s0140-6736(06)68699-6
3117:10.1016/S2213-8587(21)00235-7
2384:Chaudhry HS, Singh G (2019).
2063:10.1016/s0022-3956(01)00018-8
1856:10.1016/s0749-0739(02)00038-x
1133:
731:
170:Generally good with treatment
4511:Extramammary Paget's disease
4103:Steroid-induced osteoporosis
3614:10.1097/SLE.0b013e318290126d
2811:10.1016/j.amjmed.2005.01.059
2426:Endocrinology and Metabolism
1664:10.1016/j.amjmed.2005.01.059
1094:Persons known with Cushing's
988:
944:
691:
599:Menstrual disorders such as
538:. Cortisol can also exhibit
245:chronic feeling of tiredness
7:
3645:Annals of Internal Medicine
3294:(3). Elsevier BV: 487–509.
3245:Annals of Internal Medicine
2981:Annals of Internal Medicine
2882:10.3171/ped.2004.100.2.0212
2622:10.7326/0003-4819-111-9-758
2610:Annals of Internal Medicine
2113:(10th ed.). Saunders.
1105:
718:medroxyprogesterone acetate
381:"). Other symptoms include
10:
4608:
4341:Zollinger–Ellison syndrome
3657:10.7326/0003-4819-52-3-560
3434:10.1016/j.aace.2021.11.005
3422:AACE Clinical Case Reports
3105:Lancet Diabetes Endocrinol
2661:10.1136/bmj.301.6747.345-a
2569:10.1016/j.aace.2022.08.001
2557:AACE Clinical Case Reports
2469:Nieman LK (October 2015).
1723:10.1016/j.ejim.2011.10.013
1581:10.1016/j.aace.2022.08.001
1569:AACE Clinical Case Reports
965:UFC=urinary free cortisol.
925:of the adrenal gland with
152:Requires a number of steps
25:
18:
4539:
4486:
4462:
4453:
4430:
4377:
4354:
4321:
4237:
4216:
4173:
4145:
4138:
4111:
4096:Pseudo-Cushing's syndrome
4081:
4021:
4012:
3926:
3852:
3479:10.1007/s12020-016-1117-0
2751:10.1016/j.ecl.2012.08.002
2438:10.3803/EnM.2016.31.1.153
2392:. StatPearls Publishing.
2289:10.1080/13554790701475468
1483:10.1016/j.ecl.2011.01.006
1434:Stedman's medical eponyms
909:of the adrenal gland and
829:from a region called the
794:cortisol-binding globulin
790:pseudo-Cushing's syndrome
784:Pseudo-Cushing's syndrome
700:to treat other diseases (
670:
174:
164:
160:Based on underlying cause
156:
146:
135:
127:
117:
80:
68:
60:
51:
43:
38:
4557:Paraneoplastic pemphigus
4315:Paraneoplastic syndromes
3071:Blevins LS, ed. (2002).
2960:Ectopic Cushing syndrome
809:is in the brain and the
572:Muscle and bone weakness
19:Not to be confused with
4582:Adrenal gland disorders
4473:Erythema gyratum repens
4445:Hypertrophic osteopathy
4073:Pseudohypoaldosteronism
3040:10.3171/2008.8.JNS08339
3028:Journal of Neurosurgery
2903:Katz J (October 1992).
2870:Journal of Neurosurgery
868:paraneoplastic syndrome
661:melanocortin 1 receptor
387:dilation of capillaries
361:Symptoms include rapid
4006:Adrenal gland disorder
3963:Cushing's syndrome
3697:10.1210/jcem.86.1.7093
3344:10.1210/jc.2003-030871
2204:10.1210/jcem.82.3.3834
1976:10.1210/jcem.83.9.5084
1477:(2): 379–91, viii–ix.
1169:10.1186/2049-6958-7-26
1062:
974:
358:
350:
335:
237:irregular menstruation
139:Prolonged exposure to
4239:Adrenal insufficiency
4036:Primary aldosteronism
3564:on September 9, 2012.
2929:10.1136/jcp.s1-3.1.11
2847:10.1210/jcem-63-3-770
1811:Etienne Cote (2014).
1117:Adrenal insufficiency
1044:
952:
900:bitemporal hemianopia
743:is released from the
722:adrenal insufficiency
377:), and on the face ("
356:
341:
333:
4552:Pyoderma gangrenosum
4501:Ichthyosis acquisita
4496:Acanthosis nigricans
3838:"Cushing's Syndrome"
3786:10.1210/jc.2009-0290
3527:10.1210/jc.2004-2361
2711:10.1210/jc.2015-1218
2357:"Cushing's Syndrome"
1532:10.1210/jc.2015-2497
1272:"Cushing's Syndrome"
888:physical examination
712:, and also used for
710:rheumatoid arthritis
629:Hypercholesterolemia
520:acanthosis nigricans
490:Other signs include
4412:Transverse myelitis
4397:Limbic encephalitis
4257:Xanthogranulomatous
2921:1992Natur.359..769K
2487:10.1530/EJE-15-0464
2232:Psychiatry Research
2153:10.1530/EJE-14-1101
1925:10.1155/2009/168749
1850:(3): 533–43, viii.
1278:on 10 February 2015
643:may also result in
500:high blood pressure
492:increased urination
197:high blood pressure
87:High blood pressure
4526:Pityriasis rotunda
4346:Cushing's syndrome
4091:Cushing's syndrome
4031:Hyperaldosteronism
3927:External resources
3742:10.1002/cncr.20412
3073:Cushing's syndrome
2965:2013-10-02 at the
2787:2011-04-10 at the
2782:Cushing's Syndrome
2386:"Cushing Syndrome"
2010:(Suppl 1): 86–90.
2004:Neuroendocrinology
1884:. March 28, 2013.
1878:"Cushing syndrome"
1750:Neuroendocrinology
1690:www.mayoclinic.org
1235:"Cushing syndrome"
1098:In February 2024,
1063:
975:
898:, causing typical
596:Sleep disturbances
593:Immune suppression
508:insulin resistance
494:(and accompanying
450:insulin resistance
446:metabolic syndrome
359:
351:
336:
326:Signs and symptoms
274:disorders such as
185:Cushing's syndrome
39:Cushing's syndrome
4569:
4568:
4565:
4564:
4521:Leser-Trélat sign
4392:Encephalomyelitis
4281:
4280:
4277:
4276:
4264:Addison's disease
4153:Hypoaldosteronism
4134:
4133:
4063:Liddle's syndrome
3972:
3971:
3719:Ezzat S, Asa SL,
3082:978-1-4020-7131-7
2805:(12): 1340–1346.
2095:978-1-58562-239-9
2017:10.1159/000314213
1763:10.1159/000314297
1658:(12): 1340–1346.
1431:Forbis P (2005).
1119:(hypocortisolism)
1112:Addison's disease
1088:venous thrombosis
1068:Nelson's syndrome
1002:replacement with
999:pituitary adenoma
890:to determine any
853:pituitary adenoma
849:Cushing's disease
835:negative feedback
757:Cushing's disease
714:immunosuppression
647:. This is due to
645:hyperpigmentation
635:Hyperpigmentation
584:Diabetes mellitus
566:Rapid weight gain
540:mineralocorticoid
516:diabetes mellitus
476:are also common.
474:anxiety disorders
268:Cushing's disease
264:pituitary adenoma
262:. Cases due to a
201:abdominal obesity
182:
181:
148:Diagnostic method
91:abdominal obesity
62:Facial appearance
33:Medical condition
4599:
4460:
4459:
4308:
4301:
4294:
4285:
4284:
4143:
4142:
4046:Bartter syndrome
4019:
4018:
3999:
3992:
3985:
3976:
3975:
3850:
3849:
3845:
3824:
3823:
3821:
3819:
3804:
3798:
3797:
3780:(8): 2743–2750.
3769:
3763:
3762:
3744:
3716:
3710:
3709:
3699:
3675:
3669:
3668:
3640:
3634:
3633:
3597:
3591:
3590:
3588:
3587:
3572:
3566:
3565:
3554:
3548:
3547:
3529:
3520:(5): 3077–3083.
3505:
3499:
3498:
3462:
3456:
3455:
3445:
3413:
3407:
3406:
3370:
3364:
3363:
3326:
3320:
3319:
3283:
3277:
3276:
3240:
3234:
3233:
3197:
3191:
3190:
3162:
3153:
3152:
3146:
3138:
3128:
3096:
3087:
3086:
3068:
3062:
3061:
3051:
3019:
3013:
3012:
2976:
2970:
2957:
2951:
2950:
2940:
2900:
2894:
2893:
2865:
2859:
2858:
2829:
2823:
2822:
2779:
2773:
2772:
2762:
2730:
2724:
2723:
2713:
2704:(6): 2171–2180.
2689:
2683:
2682:
2672:
2640:
2634:
2633:
2605:
2599:
2598:
2588:
2548:
2542:
2541:
2529:
2523:
2515:
2509:
2508:
2498:
2466:
2460:
2459:
2449:
2417:
2408:
2407:
2405:
2404:
2381:
2372:
2371:
2369:
2367:
2353:
2344:
2343:
2315:
2309:
2308:
2272:
2266:
2265:
2255:
2223:
2217:
2216:
2206:
2182:
2176:
2175:
2165:
2155:
2131:
2125:
2124:
2106:
2100:
2099:
2081:
2075:
2074:
2046:
2040:
2039:
2029:
2019:
1995:
1989:
1988:
1978:
1969:(9): 3083–3088.
1954:
1948:
1947:
1937:
1927:
1903:
1897:
1896:
1894:
1893:
1874:
1868:
1867:
1839:
1833:
1832:
1808:
1802:
1801:
1799:
1797:
1782:
1776:
1775:
1765:
1756:(Suppl 1): 1–5.
1741:
1735:
1734:
1706:
1700:
1699:
1697:
1696:
1682:
1676:
1675:
1643:
1637:
1636:
1634:
1632:
1617:
1611:
1610:
1600:
1560:
1554:
1553:
1543:
1511:
1505:
1504:
1494:
1462:
1453:
1452:
1428:
1422:
1421:
1419:
1417:
1402:
1389:
1388:
1386:
1384:
1369:
1358:
1357:
1355:
1353:
1338:
1325:
1324:
1322:
1320:
1305:
1288:
1287:
1285:
1283:
1268:
1251:
1250:
1248:
1246:
1231:
1225:
1224:
1222:
1220:
1205:
1192:
1191:
1181:
1171:
1147:
831:zona fasciculata
552:gastrointestinal
512:high blood sugar
496:increased thirst
56:
36:
35:
4607:
4606:
4602:
4601:
4600:
4598:
4597:
4596:
4572:
4571:
4570:
4561:
4535:
4482:
4449:
4440:Dermatomyositis
4432:Musculoskeletal
4426:
4373:
4350:
4317:
4312:
4282:
4273:
4233:
4212:
4169:
4130:
4107:
4077:
4008:
4003:
3973:
3968:
3967:
3922:
3921:
3861:
3836:
3833:
3828:
3827:
3817:
3815:
3805:
3801:
3770:
3766:
3717:
3713:
3676:
3672:
3641:
3637:
3598:
3594:
3585:
3583:
3573:
3569:
3556:
3555:
3551:
3506:
3502:
3463:
3459:
3414:
3410:
3371:
3367:
3327:
3323:
3284:
3280:
3241:
3237:
3198:
3194:
3163:
3156:
3140:
3139:
3111:(12): 847–875.
3097:
3090:
3083:
3069:
3065:
3020:
3016:
2987:(12): 980–991.
2977:
2973:
2967:Wayback Machine
2958:
2954:
2905:"Motive to sin"
2901:
2897:
2866:
2862:
2830:
2826:
2789:Wayback Machine
2780:
2776:
2731:
2727:
2690:
2686:
2641:
2637:
2606:
2602:
2549:
2545:
2530:
2526:
2516:
2512:
2467:
2463:
2418:
2411:
2402:
2400:
2382:
2375:
2365:
2363:
2355:
2354:
2347:
2332:10.1002/bsl.802
2316:
2312:
2273:
2269:
2238:(2–3): 91–100.
2224:
2220:
2183:
2179:
2132:
2128:
2121:
2107:
2103:
2096:
2082:
2078:
2047:
2043:
1996:
1992:
1955:
1951:
1904:
1900:
1891:
1889:
1876:
1875:
1871:
1840:
1836:
1825:
1809:
1805:
1795:
1793:
1784:
1783:
1779:
1742:
1738:
1707:
1703:
1694:
1692:
1684:
1683:
1679:
1644:
1640:
1630:
1628:
1619:
1618:
1614:
1561:
1557:
1526:(10): 3928–33.
1512:
1508:
1463:
1456:
1445:
1429:
1425:
1415:
1413:
1404:
1403:
1392:
1382:
1380:
1371:
1370:
1361:
1351:
1349:
1340:
1339:
1328:
1318:
1316:
1307:
1306:
1291:
1281:
1279:
1270:
1269:
1254:
1244:
1242:
1233:
1232:
1228:
1218:
1216:
1207:
1206:
1195:
1148:
1141:
1136:
1108:
1096:
1080:corticosteroids
1076:
1060:
1058:
1056:
1054:
1052:
1050:
1048:
1046:
1010:is imperative.
991:
972:
970:
968:
966:
964:
962:
960:
958:
956:
954:
947:
927:iodocholesterol
915:pituitary gland
811:pituitary gland
803:
801:Pathophysiology
786:
745:pituitary gland
734:
698:glucocorticoids
694:
673:
637:
383:excess sweating
367:central obesity
328:
213:facial plethora
189:glucocorticoids
34:
31:
24:
21:Cushing's triad
17:
12:
11:
5:
4605:
4595:
4594:
4589:
4584:
4567:
4566:
4563:
4562:
4560:
4559:
4554:
4549:
4543:
4541:
4537:
4536:
4534:
4533:
4528:
4523:
4518:
4513:
4508:
4503:
4498:
4492:
4490:
4488:Papulosquamous
4484:
4483:
4481:
4480:
4475:
4469:
4467:
4457:
4451:
4450:
4448:
4447:
4442:
4436:
4434:
4428:
4427:
4425:
4424:
4419:
4414:
4409:
4404:
4399:
4394:
4389:
4383:
4381:
4375:
4374:
4372:
4371:
4366:
4360:
4358:
4352:
4351:
4349:
4348:
4343:
4338:
4333:
4331:Hypercalcaemia
4327:
4325:
4319:
4318:
4311:
4310:
4303:
4296:
4288:
4279:
4278:
4275:
4274:
4272:
4271:
4266:
4261:
4260:
4259:
4249:
4247:Adrenal crisis
4243:
4241:
4235:
4234:
4232:
4231:
4226:
4220:
4218:
4214:
4213:
4211:
4210:
4209:
4208:
4203:
4198:
4193:
4188:
4177:
4175:
4171:
4170:
4168:
4167:
4166:
4165:
4160:
4149:
4147:
4140:
4136:
4135:
4132:
4131:
4129:
4128:
4123:
4117:
4115:
4109:
4108:
4106:
4105:
4100:
4099:
4098:
4087:
4085:
4079:
4078:
4076:
4075:
4070:
4065:
4060:
4055:
4054:
4053:
4048:
4043:
4033:
4027:
4025:
4016:
4010:
4009:
4002:
4001:
3994:
3987:
3979:
3970:
3969:
3966:
3965:
3954:
3952:article/117365
3943:
3931:
3930:
3928:
3924:
3923:
3920:
3919:
3908:
3893:
3878:
3862:
3857:
3856:
3854:
3853:Classification
3847:
3846:
3832:
3831:External links
3829:
3826:
3825:
3799:
3764:
3735:(3): 613–619.
3711:
3690:(1): 117–123.
3670:
3651:(3): 560–569.
3635:
3608:(3): 324–328.
3592:
3567:
3549:
3500:
3473:(2): 555–563.
3457:
3428:(3): 105–108.
3408:
3381:(5): 516–521.
3365:
3321:
3278:
3235:
3192:
3154:
3088:
3081:
3063:
3034:(3): 531–539.
3014:
2971:
2952:
2895:
2860:
2841:(3): 770–775.
2824:
2774:
2745:(4): 793–803.
2725:
2684:
2635:
2616:(9): 758–760.
2600:
2563:(6): 239–242.
2543:
2524:
2510:
2481:(4): M33–M38.
2461:
2432:(1): 153–160.
2409:
2373:
2345:
2310:
2283:(3): 189–200.
2267:
2218:
2197:(3): 912–919.
2177:
2126:
2119:
2101:
2094:
2076:
2057:(3): 127–145.
2041:
1990:
1949:
1898:
1869:
1834:
1823:
1803:
1788:. 2012-11-30.
1777:
1736:
1717:(3): 278–282.
1701:
1677:
1638:
1623:. 2012-11-30.
1612:
1575:(6): 239–242.
1555:
1506:
1454:
1443:
1423:
1408:. 2012-11-30.
1390:
1375:. 2012-11-30.
1359:
1344:. 2012-11-30.
1326:
1311:. 2012-11-30.
1289:
1252:
1239:mayoclinic.org
1226:
1211:. 2012-11-30.
1193:
1138:
1137:
1135:
1132:
1131:
1130:
1125:
1120:
1114:
1107:
1104:
1095:
1092:
1075:
1072:
1004:hydrocortisone
990:
987:
946:
943:
931:petrosal sinus
919:incidentalomas
879:glucocorticoid
802:
799:
785:
782:
781:
780:
777:
767:paraneoplastic
763:
760:
749:adrenal glands
733:
730:
693:
690:
685:adrenal cortex
672:
669:
636:
633:
632:
631:
626:
621:
616:
610:
604:
597:
594:
591:
586:
581:
576:
573:
570:
567:
534:and increased
498:), persistent
427:oligomenorrhea
343:Increased hair
327:
324:
320:Harvey Cushing
280:Carney complex
260:adrenal glands
209:round red face
180:
179:
176:
172:
171:
168:
162:
161:
158:
154:
153:
150:
144:
143:
137:
133:
132:
129:
125:
124:
121:
115:
114:
113:, fragile skin
84:
78:
77:
72:
66:
65:
58:
57:
49:
48:
45:
41:
40:
32:
15:
9:
6:
4:
3:
2:
4604:
4593:
4590:
4588:
4585:
4583:
4580:
4579:
4577:
4558:
4555:
4553:
4550:
4548:
4545:
4544:
4542:
4538:
4532:
4529:
4527:
4524:
4522:
4519:
4517:
4514:
4512:
4509:
4507:
4504:
4502:
4499:
4497:
4494:
4493:
4491:
4489:
4485:
4479:
4476:
4474:
4471:
4470:
4468:
4466:
4461:
4458:
4456:
4455:Mucocutaneous
4452:
4446:
4443:
4441:
4438:
4437:
4435:
4433:
4429:
4423:
4420:
4418:
4415:
4413:
4410:
4408:
4405:
4403:
4400:
4398:
4395:
4393:
4390:
4388:
4385:
4384:
4382:
4380:
4376:
4370:
4367:
4365:
4362:
4361:
4359:
4357:
4356:Hematological
4353:
4347:
4344:
4342:
4339:
4337:
4334:
4332:
4329:
4328:
4326:
4324:
4320:
4316:
4309:
4304:
4302:
4297:
4295:
4290:
4289:
4286:
4270:
4267:
4265:
4262:
4258:
4255:
4254:
4253:
4250:
4248:
4245:
4244:
4242:
4240:
4236:
4230:
4227:
4225:
4222:
4221:
4219:
4215:
4207:
4204:
4202:
4199:
4197:
4194:
4192:
4189:
4187:
4184:
4183:
4182:
4179:
4178:
4176:
4172:
4164:
4161:
4159:
4156:
4155:
4154:
4151:
4150:
4148:
4144:
4141:
4137:
4127:
4124:
4122:
4119:
4118:
4116:
4114:
4110:
4104:
4101:
4097:
4094:
4093:
4092:
4089:
4088:
4086:
4084:
4080:
4074:
4071:
4069:
4066:
4064:
4061:
4059:
4056:
4052:
4049:
4047:
4044:
4042:
4041:Conn syndrome
4039:
4038:
4037:
4034:
4032:
4029:
4028:
4026:
4024:
4020:
4017:
4015:
4014:Hyperfunction
4011:
4007:
4000:
3995:
3993:
3988:
3986:
3981:
3980:
3977:
3964:
3960:
3959:
3955:
3953:
3949:
3948:
3944:
3942:
3938:
3937:
3933:
3932:
3929:
3925:
3918:
3914:
3913:
3909:
3907:
3903:
3902:
3898:
3894:
3892:
3888:
3887:
3883:
3879:
3877:
3873:
3872:
3868:
3864:
3863:
3860:
3855:
3851:
3843:
3839:
3835:
3834:
3814:
3810:
3803:
3795:
3791:
3787:
3783:
3779:
3775:
3768:
3760:
3756:
3752:
3748:
3743:
3738:
3734:
3730:
3726:
3722:
3715:
3707:
3703:
3698:
3693:
3689:
3685:
3681:
3674:
3666:
3662:
3658:
3654:
3650:
3646:
3639:
3631:
3627:
3623:
3619:
3615:
3611:
3607:
3603:
3596:
3582:
3578:
3571:
3563:
3559:
3553:
3545:
3541:
3537:
3533:
3528:
3523:
3519:
3515:
3511:
3504:
3496:
3492:
3488:
3484:
3480:
3476:
3472:
3468:
3461:
3453:
3449:
3444:
3439:
3435:
3431:
3427:
3423:
3419:
3412:
3404:
3400:
3396:
3392:
3388:
3384:
3380:
3376:
3369:
3361:
3357:
3353:
3349:
3345:
3341:
3337:
3333:
3325:
3317:
3313:
3309:
3305:
3301:
3297:
3293:
3289:
3282:
3274:
3270:
3266:
3262:
3258:
3254:
3250:
3246:
3239:
3231:
3227:
3223:
3219:
3215:
3211:
3207:
3203:
3196:
3188:
3184:
3180:
3176:
3172:
3168:
3161:
3159:
3150:
3144:
3136:
3132:
3127:
3122:
3118:
3114:
3110:
3106:
3102:
3095:
3093:
3084:
3078:
3074:
3067:
3059:
3055:
3050:
3045:
3041:
3037:
3033:
3029:
3025:
3018:
3010:
3006:
3002:
2998:
2994:
2990:
2986:
2982:
2975:
2968:
2964:
2961:
2956:
2948:
2944:
2939:
2934:
2930:
2926:
2922:
2918:
2915:(6398): 769.
2914:
2910:
2906:
2899:
2891:
2887:
2883:
2879:
2875:
2871:
2864:
2856:
2852:
2848:
2844:
2840:
2836:
2828:
2820:
2816:
2812:
2808:
2804:
2800:
2796:
2790:
2786:
2783:
2778:
2770:
2766:
2761:
2756:
2752:
2748:
2744:
2740:
2736:
2729:
2721:
2717:
2712:
2707:
2703:
2699:
2695:
2688:
2680:
2676:
2671:
2666:
2662:
2658:
2655:(6747): 345.
2654:
2650:
2646:
2639:
2631:
2627:
2623:
2619:
2615:
2611:
2604:
2596:
2592:
2587:
2582:
2578:
2574:
2570:
2566:
2562:
2558:
2554:
2547:
2539:
2535:
2528:
2521:
2514:
2506:
2502:
2497:
2492:
2488:
2484:
2480:
2476:
2472:
2465:
2457:
2453:
2448:
2443:
2439:
2435:
2431:
2427:
2423:
2416:
2414:
2399:
2395:
2391:
2387:
2380:
2378:
2362:
2358:
2352:
2350:
2341:
2337:
2333:
2329:
2325:
2321:
2314:
2306:
2302:
2298:
2294:
2290:
2286:
2282:
2278:
2271:
2263:
2259:
2254:
2249:
2245:
2241:
2237:
2233:
2229:
2222:
2214:
2210:
2205:
2200:
2196:
2192:
2188:
2181:
2173:
2169:
2164:
2159:
2154:
2149:
2145:
2141:
2137:
2130:
2122:
2120:0-7216-2921-0
2116:
2112:
2105:
2097:
2091:
2087:
2080:
2072:
2068:
2064:
2060:
2056:
2052:
2045:
2037:
2033:
2028:
2023:
2018:
2013:
2009:
2005:
2001:
1994:
1986:
1982:
1977:
1972:
1968:
1964:
1960:
1953:
1945:
1941:
1936:
1931:
1926:
1921:
1917:
1913:
1909:
1902:
1887:
1883:
1879:
1873:
1865:
1861:
1857:
1853:
1849:
1845:
1838:
1830:
1826:
1824:9780323240741
1820:
1816:
1815:
1807:
1791:
1787:
1781:
1773:
1769:
1764:
1759:
1755:
1751:
1747:
1740:
1732:
1728:
1724:
1720:
1716:
1712:
1705:
1691:
1687:
1681:
1673:
1669:
1665:
1661:
1657:
1653:
1649:
1642:
1626:
1622:
1616:
1608:
1604:
1599:
1594:
1590:
1586:
1582:
1578:
1574:
1570:
1566:
1559:
1551:
1547:
1542:
1537:
1533:
1529:
1525:
1521:
1517:
1510:
1502:
1498:
1493:
1488:
1484:
1480:
1476:
1472:
1468:
1461:
1459:
1450:
1446:
1444:9780781754439
1440:
1436:
1435:
1427:
1411:
1407:
1401:
1399:
1397:
1395:
1378:
1374:
1368:
1366:
1364:
1347:
1343:
1337:
1335:
1333:
1331:
1314:
1310:
1304:
1302:
1300:
1298:
1296:
1294:
1277:
1273:
1267:
1265:
1263:
1261:
1259:
1257:
1241:. Mayo Clinic
1240:
1236:
1230:
1214:
1210:
1204:
1202:
1200:
1198:
1189:
1185:
1180:
1175:
1170:
1165:
1161:
1157:
1153:
1146:
1144:
1139:
1129:
1126:
1124:
1121:
1118:
1115:
1113:
1110:
1109:
1103:
1101:
1091:
1089:
1084:
1081:
1071:
1069:
1043:
1039:
1037:
1033:
1032:hyperglycemia
1029:
1028:abortifacient
1024:
1020:
1016:
1011:
1009:
1005:
1000:
995:
986:
982:
979:
951:
942:
940:
935:
932:
928:
924:
920:
916:
912:
908:
903:
901:
897:
893:
889:
885:
880:
876:
871:
869:
865:
860:
858:
854:
850:
846:
843:
838:
836:
832:
828:
827:adrenal gland
824:
820:
816:
812:
808:
798:
795:
791:
778:
775:
772:
768:
764:
761:
758:
754:
753:
752:
750:
746:
742:
738:
729:
726:
723:
719:
715:
711:
707:
703:
699:
689:
686:
682:
677:
668:
664:
662:
658:
654:
650:
646:
642:
630:
627:
625:
622:
620:
617:
614:
611:
608:
605:
602:
598:
595:
592:
590:
587:
585:
582:
580:
577:
574:
571:
568:
565:
564:
563:
559:
557:
553:
549:
548:hypernatremia
545:
541:
537:
533:
532:heart disease
529:
525:
521:
517:
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