A Physiologic Approach to Diagnosis of the Cushing Syndrome
@article{Raff2003APA, title={A Physiologic Approach to Diagnosis of the Cushing Syndrome}, author={Hershel Raff and James W. Findling}, journal={Annals of Internal Medicine}, year={2003}, volume={138}, pages={980-991} }
Clinical Principles* General Obesity Hypertension Metabolic Diabetes mellitus or impaired glucose tolerance Hyperlipidemia Nephrolithiasis Polyuria Skin Plethora Hirsutism Striae Acne Bruising Musculoskeletal Osteopenia or osteoporosis Proximal myopathy Neuropsychiatric Depression Cognitive impairment Emotional lability Euphoria Psychosis Gonadal dysfunction Oligomenorrhea or amenorrhea Impotence, decreased libido Immune suppression (susceptible to opportunistic infection) *Notice that many of…
177 Citations
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The medical disorders and physiological conditions associated with chronic activation of the hypothalamic–pituitary–adrenal axis are described and a rational clinical and biochemical approach is provided to distinguish them from patients with neoplastic/pathological Cushing syndrome.
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The diagnosis of Cushing’s syndrome
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Recognition of patients with multiple features, features unusual for their age, patients with features more specific to Cushing’s syndrome, and patients with incidental adrenal mass or polycystic ovary syndrome should prompt an evaluation for cortisol excess.
Subclinical Cushing's syndrome due to unilateral or bilateral adrenal incidentalomas. Problems of diagnostic and indication to surgical treatment. Review of literature
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- 2005
Elevated midnight cortisol concentration is a reliable test to select a subgroup of patients with a clinically inapparent adrenal adenoma with an adverse cardiovascular risk profile and any correlation between endocrine data and clinical phenotype exists is examined.
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- MedicineEuropean journal of endocrinology
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This review will define and characterize the numerous causes of physiologic/non-neoplastic hypercortisolism and provide a rational clinical and biochemical approach to distinguish it from pathologic/neoplastics hypercortsisolism (true Cushing syndrome).
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Understanding basic physiology informs the development of new approaches to diagnosis and treatment of Cushing's syndrome, and appreciating pathophysiology generates new areas for inquiry of basic physiological and biochemical mechanisms.
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When oral or enteral medications cannot be administered and sedation is required in critically ill patients, etomidate is an appropriate intravenous agent for hypercortisolemia.
The diagnosis and differential diagnosis of endogenous Cushing's syndrome.
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This review will discuss the various causes of endogenous CS and focus on established and evolving diagnostic procedures used for its diagnosis, as several studies with large number of patients have recently appeared in the literature validating current practice and proposing improved diagnostic algorithms.
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