Cushing's Syndrome And Disease (Glucocorticoid Excess)

Etiology

  • ACTH dependent: pituitary tumor, small cell lung cancer (ectopic ACTH production)
  • ACTH independent (Cushing's Disease): Adrenal tumor
  • Exogenous steroid consumption

Symptoms

  • Hypertension
  • Easy bruising
  • Central wt gain→ neck/face/thorax/abd
  • Glucose intolerance/dm
  • Proximal muscle weakness
  • Unexplained osteoporosis
  • If ACTH dependent from pituitary tumor→ headache, visual field cuts, other pituitary hormone related symptoms; if from SCLC→ SOB, cough, etc

Physical Exam Findings

  • Hypertension
  • Obesity
  • Echymoses
  • Moon face
  • Purple/red striae
  • Posterior cervical (buffalo hump) and supraclavicular fat pads
  • Hyperpigmentation in mouth/sun exposed areas if ACTH dependent

Tests

Links