Recent Updates on the Diagnosis and Management of Cushing's Syndrome.
10.3803/EnM.2018.33.2.139
- Author:
Lynnette K NIEMAN
1
Author Information
1. Diabetes, Endocrine and Obesity Branch, The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, USA. NiemanL@nih.gov
- Publication Type:Review
- Keywords:
Cushing syndrome;
Hydrocortisone;
Adrenocorticotropic hormone
- MeSH:
Adrenocorticotropic Hormone;
Cushing Syndrome*;
Dexamethasone;
Diagnosis*;
Humans;
Hydrocortisone;
Mass Screening;
Mortality
- From:Endocrinology and Metabolism
2018;33(2):139-146
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to identify the condition at an early stage, as it tends to progress, accruing additional morbidity and increasing mortality rates. Once a clinical suspicion is raised, screening tests involve timed measurement of urine, serum or salivary cortisol at baseline or after administration of dexamethasone, 1 mg. Each test has caveats, so that the choice of tests must be individualized for each patient. Once the diagnosis is established, and the cause is determined, surgical resection of abnormal tumor/tissue is the optimal treatment. When this cannot be achieved, medical treatment (or bilateral adrenalectomy) must be used to normalize cortisol production. Recent updates in screening for and treating Cushing's syndrome are reviewed here.
