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Chapter-062a Cushing Syndrome: Symptomatology and Diagnostic Strategies

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Rajput Rajesh
ISBN
9789351526476
DOI
10.5005/jp/books/12535_77
Edition
2/e
Publishing Year
2015
Pages
4
Author Affiliations
1. Rohtak, Haryana, India, Pt. B.D. Sharma Post-Graduate Institute of Medical Sciences, Rohtak, Haryana, India, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak 124 001, Haryana, India, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, PGIMS, Rohtak, Haryana, India, Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India
Chapter keywords
Cushing’s syndrome, centripetal obesity, hirsutism, plethora, proximal muscle weakness, osteoporosis, pseudo-Cushing’s syndrome, hypercortisolemia

Abstract

Cushing’s syndrome was first described by the Harvey W Cushing in 1932 and it results from the chronic exposure to excess glucocorticoids. If it remains untreated/ undiagnosed, then it will lead to increase in morbidity and mortality. Its clinical features are: centripetal obesity, moon faces, hirsutism, plethora, red-purple striae, bruising, proximal muscle weakness, psychiatric disturbances, osteoporosis, and menstrual irregularity. While diagnosing, Cushing’s syndrome must be differentiated from pseudo-Cushing’s syndrome. Cushing’s syndrome can be diagnosed in two steps. First by establishing that patient is having hypercortisolemia and second by establishing the cause of this hypercortisolemia. The tests used for diagnosing Cushing’s syndrome are circadian rhythm of cortisol, urinary free cortisol (UFC), overnight and low-dose dexamethasone suppression test (ONDST and LDDST).

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