Cushing's syndrome
From Ganfyd
Contents |
Introduction
An eponymous syndrome after the Boston Neurosurgeon Harvey Cushing relating to cortisol excess. Also see Cushing's disease
Aetiology
Excess circulating glucocorticoids
Clinical
- Moon face
- Central obesity
- Hypertension
- Hirsutism and menstrual disorder
- Striae
- Osteoporosis with backache, vertebral collapse
- Lethargy
- Diabetes
Less commonly
- Acne
- Pigmentation
Investigations
Blood tests
U&E
- Sodium retention
- Potassium loss
- Hypokalaemic alkalosis
Low dose Dexamethasone suppression test. ( Dexamethasone 1mg orally @ midnight, serum cortisol @ 09:00. If <50mmol/lexcludes diagnosis)
High dose Dexamethasone suppression test
Radiology
Treatment
Medical
Stop or minimize exogenous steroids
Surgical
If no exogenous steroids in use suspect Cushing's disease or steroid /ACTH secreting tumour may require surgical intervenntion
