CUSHING SYNDROME-CLINICAL
SUMMARY
1. Cushing syndrome occurs when there is excessive adrenal glucocorticoid production.
2. present(s) with proximal muscle weakness and easy fatigability; amenorrhea, hirsutism, and acne in females; easy bruising; and emotional lability (sometimes frank psychosis).
3. Exam reveals facial plethora, thin skin with prominent bright pink-to-purple striae, cervicodorsal fat pad ("buffalo hump"), truncal obesity, and moon facies.
4. Because cortisol also can stimulate mineralocorticoid receptors, the patient may have edema and HTN.
5. Cushing syndrome is the general description for any state of excess cortisol and includes the specific diagnosis of Cushing disease, which refers to an ACTH-secreting pituitary tumor.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].