Condition Info - BotMed Application

ConditionName

Cushing syndrome

ConditionDescription

Symptoms

Weigh gain especially on the trunk, face;
Moon face;
Hyperhidrosis (sweating);
Hirsutism;
Buffalo hump;
Striae, easy bruising, decrease wound healing, thinning of the skin;
Polyuria;
No menses, ED;
Acne;
Hyperglycemia;

PhysicalFindings

Central obesity; high blood pressure; increased pigmentation of the skin; moon face; acne; striae of abdomen; buffalo hump

ClinicalTests

Gold standard: 24 urinary cortisol 

1mg  dexamethasone suppression test (can’t suppress cancer, but suppress ;
ANY Cushing’s syndrome or dz), late-night salivary cortisol;
PAC:PRA;
Low:low;
ACTH – always to find the source of ACTH;
Don’t start with CT scan! (MRI for pituitary);

8 mg suppression test – we can suppress only pituitary lesion;

Lab shows: high sugar and high lipids;
Low K;
Metabolic alkalosis;
Leukocytosis;

RiskFactors

females > males;
25 to 40 age group;

Obesity;
Type 2 diabetes;
Corticosteroid medications (long-term use);
Pituitary gland tumours;
A primary adrenal gland disease;
Benign nodular enlargements of the adrenal glands;
Ectopic ACTH-secreting tumour;

IsRedFlag

IsNPLEX

Consequence

Suicide;
Depression;
Cataracts;
CVD;
DM;
HTN;
Thrombosis;
Osteoporosis;
Immunity problems;

ProgressionFromCondition

Pituitary ACTH 70% (dz)
Adrenals (15%)
Carcinoid (10%)
Unknown source of ACTH 5%

TreatmentOptions

PharmOptions

WebLink

https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/adrenal-disorders/cushing-syndrome