Cushing syndrome PDF

PDF | Cushing's disease, or pituitary ACTH dependent Cushing's syndrome, is a rare disease responsible for increased morbidity and mortality Introduction. Cushing's disease (CD) is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hypercortisolism (Figure 1) 1-3.It accounts for approximately 70% of patients with endogenous Cushing's syndrome (CS); the ectopic ACTH syndrome and adrenal tumours or hyperplasia account for 10%.

(PDF) Cushing's disease - ResearchGat

Current management of Cushing's disease - Tritos - 2019

Cushing's syndrome can lead to high blood glucose, so try not to eat foods that can cause a rise in blood sugar. Examples of foods to focus on eating include vegetables, fruits, whole grains. + 1.0 Treatment goals for Cushing's syndrome 1.1 In patients with overt Cushing's syndrome (CS), we recommend normalizing cortisol levels or action at its receptors to eliminate the signs and symptoms of CS and treating comorbidities associated with hypercortisolism The most common cause of Cushing's syndrome is the use of exogenous glucocorticoids. Endogenous Cushing's syndrome is divided into corticotropin-dependent and corticotropin-independent causes: Corticotropin-dependent causes account for about 80-85% of cases: 80% are due to pituitary adenomas (Cushing's disease) Testing for Cushing's syndrome in certain high-risk populations has shown an unexpectedly high incidence of unrecognized Cushing's syndrome as compared with the general population. Although there are limited data on the prevalence of the syndrome in these disorders, the diagnosis should be considered Cushing's syndrome refers to the constellation of clinical and laboratory findings that occur in patients exposed to excess glucocorticoids. Additional manifestations often coexist when the steroids present in excess possess other activities, particularly mineralocorticoid and androgenic activities

Cushing syndrome - Symptoms, diagnosis and treatment BMJ

Cushing Syndrome - Endocrine and Metabolic Disorders - MSD

Chronic exposure to excess glucorticoids results in diverse manifestations of Cushing's syndrome, including debilitating morbidities and increased mortality. Genetic and molecular mechanisms responsible for excess cortisol secretion by primary adrenal lesions and adrenocorticotropic hormone (ACTH) secretion from corticotroph or ectopic tumours have been identified Cushing's syndrome in humans has a different origin with in the pituitary gland than the horse which is why there has been a shift to call this problem PPID in horses. The clinical disease has been well recognized for years, but the pathophysiology remains poorly understood The following Cushing's disease diet changes can help limit or counteract some symptoms: Reducing sodium intake. Excess sodium can worsen symptom's of Cushing's by increasing blood pressure and causing weight gain. Therefore, cut down on sodium by avoiding processed foods and limiting the amount of salt added to food Cushing's syndrome is the collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly Cushing's syndrome is a collection of hormonal disorders characterised by high levels of the hormone cortisol. Another name for Cushing's syndrome is hypercortisolism. Some people have Cushing's syndrome symptoms when they take glucocorticoid hormones to treat inflammatory conditions such as asthma, lupus or rheumatoid arthritis

Cushing's syndrome - SlideShar

Cushing syndrome (CS) is a disorder characterized by a result of chronic exposure to excessive glucocorticoids. This article describes a case of a 30-year-old female presenting with fatigue, abdominal striae, unintentional weight gain, and lipodystrophy. A rare diagnosis of ectopic adrenocorticotropic-dependent CS was determined and a neuroendocrine lung tumor (NET) was discovered on chest x-ray hypercortisolemia in Cushing syndrome is usually due to corticotrophin (ACTH) producing pituitary tumor (Cushing disease), ectopic ACTH secretion by a nonpituitary tumor or cortisol secretion by adrenal adenoma or carcinoma. Signs and symptoms: Treatment The hypercortisolism of Cushing syndrome is primarily treated surgically ushing's syndrome (CS) is caused by prolonged supraphysiological levels of circulating cortisol. Cushing's disease (CD) is the most common etiolo-gy (70%-80% of CS cases) of endogenous CS. It is caused by a pituitary adenoma that secretes adrenocorticotropic hormone (ACTH), which stimulates secretion of cortisol by the adrenal glands Cushing's syndrome André Lacroix, Richard A Feelders, Constantine A Stratakis, Lynnette K Nieman Chronic exposure to excess glucorticoids results in diverse manifestations of Cushing's syndrome, including debilitating morbidities and increased mortality. Genetic and molecular mechanisms responsible for excess cortiso View Cushings Syndrome .pdf from FITN 115 at Raritan Valley Community College. System Disorder ACTIVE LEARNING TEMPLATE: STUDENT NAME_ Cushing's Syndrome DISORDER/DISEASE PROCESS_ REVIEW MODUL

Cushing's syndrome (CS) is a condition caused by prolonged exposure to elevated levels of glucocorticoids either endogenous or exogenous. The most common cause of CS is exogenous and depends on frequency and spectrum of medical condition which . Download Full PDF Package Cushing's disease (and by extension, Cushing's syndrome) is a rare disease due to a chronic cortisol excess, which usually has an important impact on quality of life (QoL) Cushing's syndrome reflects the physical and mental changes that happen in the body from having too much cortisol in the blood for a long period of time. Cortisol is a steroid hormone produced by the adrenal glands (which are above the kidneys) Cushing's syndrome is a disorder of the endocrine system. Cushing's syndrome (Cushing's disease, Hypercortisolism, Adrenal Hyperfunction) is a cluster of clinical abnormalities caused by excessive levels of adrenocortical hormones (particularly cortisol) or related corticosteroids and, to a lesser extent, androgens and aldosterone.; The prognosis depends on the underlying cause; it's.

What is Cushing syndrome? A Cushing syndrome is a group of symptoms that develop as a result of an extremely high cortisol level in the body. Hence, the condition is also called hypercortisolism. There are a variety of reasons why the level of cortisol goes out of control. (1, 2, and 3 Therefore, the true incidence might be underestimated. In a European population based study, the annual incidence of endogenous Cushing syndrome was reported to be 1.2-1.7 per million per year (Cushing disease), 0.6 per million per year (adrenal adenoma), and 0.2 per million per year (adrenal carcinoma) Cushing syndrome is that Addison disease is characterized by the hormonal insufficiency of cortisol and aldosterone whereas Cushing syndrome is characterized by an excess of cortisol. In prescribing the . anti-inflammatory corticosteroids, the patient should be followed up to prevent the development of unnecessary and avoidable complications.

Cushing's syndrome (CS) is the state of hypercortisolism that results from endogenous or exogenous glucocorticoid excess. It is associated with increased morbidity and mortality from musculoskeletal, metabolic, thrombotic, infectious and cardiovascular complications. Cushing syndromeis a rare disorder in which the adrenal glands(small glands on top of the kidneys) make too much of a hormone called cortisol. In normal amounts, cortisol (sometimes called the stress hormone) helps the body respond appropriately to stress. Cortisol also helps maintain blood sugar levels and blood pressure Cushing's Disease Focussed Examination Note: the instructions may be non-specific e.g. 'examine this patient's endocrine status' (could be Cushing's, acromegaly or hypothyroidism). In this case, approach by asking a few focussed questions (if allowed) and doing a general inspection to determine whic Cushing's disease, or pituitary ACTH dependent Cushing's syndrome, is a rare disease responsible for increased morbidity and mortality. Signs and symptoms of hypercortisolism are usually non specific: obesity, signs of protein wasting, increased blood pressure, variable levels of hirsutism. Diagnosis is frequently difficult, and requires a strict algorithm. First-line treatment is based on. The most common endogenous cause of Cushing's syndrome is Cushing's disease. Frequent clinical findings include weight gain, truncal obesity, striae, hypertension, glucose intolerance and infections

Cushing's syndrome is a series of physical problems that are caused when the level of cortisol or other similar corticosteroids in the blood is too high. Symptoms of Cushing's Syndrome: Patients have a rounded appearance to the face and the face often appears reddish or florid, and fingers and toes are long and thin.. These conditions that mimic Cushing's syndrome are called 'pseudo-Cushing's states' and include the conditions shown in Table 2. Because of the similarity in symptoms and laboratory test results between Cushing's syndrome and pseudo-Cushing's states, doctors may have to do a number of tests and may have to treat conditions that. A Client with Cushing's Syndrome Sara Domico is a 30-year-old lawyer living in a major metropolitan area. She has never been married,and she shares her life with her cat,Beau,and her parents, who live nearby.Her physician recently diagnosed Ms.Domico as having Cushing's syndrome and admits her to the hospital for sur The skin manifestations of Cushing syndrome (excess cortisol) reflect the excess of glucocorticoids. This causes accumulation of fatty tissue in a characteristic distribution (facial, truncal and cervical) causing the 'moon face', 'lemon on stick' appearance and 'buffalo hump')..

Cushing syndrome - Symptoms and causes - Mayo Clini

Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol. The most common cause of Cushing syndrome is taking too much glucocorticosteroid medicine. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine Cushing syndrome caused by corticosteroid use. Doctor will instruct to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous. If cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored Cushing's Syndrome/Disease Information for Patients - The Neuroendocrine & Pituitary Tumor Clinical Center offers detailed outpatient evaluation of all disorders affecting the endocrine function of the hypothalamus and pituitary gland, achieved through comprehensive office visits, complete basal and dynamic hormone testing, and coordination of radiologic studies and visual field evaluations Cushing's syndrome is a hormonal disorder. The cause is long-term exposure to too much cortisol, a hormone that your adrenal gland makes. Sometimes, taking synthetic hormone medicine to treat an inflammatory disease leads to Cushing's. Some kinds of tumors produce a hormone that can cause your body to make too much cortisol Terminology. Cushing disease refers to glucocorticoid excess solely due to an adrenocorticotropic hormone-secreting pituitary adenoma, while Cushing syndrome encompasses all etiologies of glucocorticoid excess 6.. Clinical presentation. Typically, patients have the following clinical features 6:. rounded face, sometimes described as 'moon-shaped

Cushing's disease: pathobiology, diagnosis, and management

Other patients have Cushing's syndrome because they make too much of the hormone ACTH, which causes the adrenal glands to make cortisol. When the ACTH comes from the pituitary gland it is called Cushing's disease. Cushing's syndrome is fairly rare. It is more often found in women than in men and often occurs between the ages of 20 and 40 An estimated 10-15 per million people are affected every year. Pituitary adenomas (Cushing's disease) account for more than 70 percent of cases in adults and about 60-70 percent of cases in children and adolescents.; Cushing's syndrome most commonly affects adults ages 20-50 and is more prevalent in females, accounting for about 70 percent of all cases Printable PDF Version. Overview. or Cushing's Syndrome. About 80 years ago, Dr. Harvey Cushing is credited for being the first to describe a group of people, each ill due to chronic excesses in cortisone. This is why some refer to the disease using his last name. A tumor producing excess cortisone can develop in either adrenal gland Issues in the treatment of Cushing's syndrome (CS) - relative importance of specific and symptomatic treatments. Chronic glucocorticoid excess results in numerous co-morbidities that impair quality of life and increased mortality [].Cardiovascular disease and infections are the most frequent causes of deaths in relation with Cushing's syndrome [1,2]

Treatment of Cushing's Syndrome: An Endocrine Society

  1. Cushing syndrome (CS) is a state of glucocorticoid excess in which there is loss of the normal hypothalamic-pituitary-adrenal feedback axis. First described in 1912 by American neurosurgeon Dr Harvey Williams Cushing in reference to a 23-year-old patient with obesity, hirsutism, and amenorrhea, CS has since been recognized as a rare, yet serious and significant, condition in the pediatric.
  2. EQUINE CUSHING'S DISEASE Patrick M. McCue DVM, PhD, Diplomate American College of Theriogenologists Equine Cushing's disease is a complex progressive disease of the pituitary gland of middle age to older horses. The pituitary gland is a small structure located at the base of the brain which produces hormones that regulate many body functions
  3. Cushing's syndrome is a debilitating disorder which requires rapid reversal of hypercortisolemia to limit morbidity. The primary treatment for Cushing's syndrome remains surgical although residual.
  4. Endogenous Cushing's disease is commonly reported in poodles, dachshunds, and terriers. It can be seen in any breed and mixed breeds as well. The average reported age is 8 years, but can range from very young (3 years) to very old (>12 years). There is no particular sex predilection
  5. Signs and symptoms of Cushing's syndrome. Cushing's syndrome is caused by chronic exposure to excess cortisol. Its associated comorbidities contribute to a decreased quality of life and an increased standardized mortality rate compared to the general population (2, 3, 4, 5).Although some studies show an increased mortality regardless of remission status , most studies indicate that an early.
  6. Cushing's disease is one cause of Cushing's syndrome characterised by increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary (secondary hypercortisolism).This is most often as a result of a pituitary adenoma (specifically pituitary basophilism) or due to excess production of hypothalamus CRH (corticotropin releasing hormone) (tertiary hypercortisolism.

Cushing's Syndrome NIDD

  1. Cushing syndrome, first described by Harvey in 1912, refers to signs and symptoms caused by excess free plasma glucocorticoids. Excess glucocorticoids can be from increased endogenous production or prolonged exposure to exogenous use of glucocorticoid products. While endogenous Cushing syndrome is a rare disease, iatrogenic (drug-related or.
  2. The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body's natural hormone cortisol
  3. Cushing syndrome, primary aldosteronism, or hyperandrogenism. Treatment may involve removal of part or all of the adrenal gland, which may be preceded by drug therapy to reduce cortisol production prior to surgery. 8 Glucocorticoid medication-induced Cushing syndrome is known as iatrogenic Cushing syndrome. Oral manifestation

Cushing s Syndrome Cushing's Syndrome provides the reader with an update on the clinical presentation, diagnosis, and treatment of patients with Cushing's syndrome. Molecular mechanisms of pituitary and adrenal causes of Cushing's syndrome are reviewed in detail 2808 Nieman et al Guidelines on Cushing's Syndrome Treatment J Clin Endocrinol Metab, August 2015, 100(8):2807-2831. ACTH-dependent disease who cannot be promptly con-trolled by medical therapy. (2 QQQE) 6.1b We recommend regularly evaluating for cortico diagnosis of Cushing's disease from EAS in ACTH-dependent Cushing's syndrome is thus a challenging problem in clinical endocrinology. Diagnostic criteria for Cushing's disease were estab-lished by the working group of the Ministry of Health, Labour, and Welfare, Japan [3, 4]. Diagnostic crite Cushing's syndrome causes clinical features diagnosis establishing the cause - The most common cause of Cushing's syndrome is use of supraphysiological amounts of exogenous glucocorticoids, including topical or inhaled corticosteroids (iatrogenic Cushing's syndrome). Thus, adequate knowledge of an individual's medication history is essential. in association with Cushing's disease. Perhapsthis is because plasmacortisols arenotgrossly evaluatedin Cushing'sdisease,althoughtheymaybeinCushing's syndrome due to ectopic ACTHproduction. In the present case, as in other reported cases, it is difficult to separate the effects ofsteroid excessfromconcur-rent drugtherapy. Cytotoxicdrugs.

Cushings syndrome is associated with a hypercoagulable state in both dogs and humans. One study (Jacoby RC, et al, Arch Surg, 2001 Sept;136(9):1003-6) showed that levels of procoagulation factors II, V, VII, IX, X, XI, and fibrinogen were significantly increased in dog The most frequent cause of Cushing's syndrome is iatrogenic, as Cushing's syndrome is the unavoidable consequence of long-term glucocorticoid treatment using more than 7.5 mg prednisone per day. The most frequent cause of endogenous Cushing's syndrome is Cushing's disease (CD), which is an ACTH depe

Cushing's Syndrome: Signs, Causes, and Treatmen

In adrenal Cushing syndrome, independent steroid production by the adrenal gland occurs, usually resulting in suppression of ACTH. In exogenous Cushing syndrome, administration of an exogenous glucocorticoid suppresses the whole hypothalamus-pituitary-adrenal axis, resulting in low ACTH and dehydroepiandrosterone sulfate levels . Endogenous Cushing syndrome is uncommon, with an incidence of two to three per million per year Cushing's syndrome is an endocrine disorder caused when the adrenal glands produce excess cortisol. Also known as hypercortisolism, Cushing's syndrome can occur for various reasons. One of the most common causes is long-term exposure to corticosteroid medications like prednisone Cushing's Disease. Cushing's disease is a serious condition of an excess of the steroid hormone cortisol in the blood level caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). ACTH is a hormone produced by the normal pituitary gland. ACTH stimulates the adrenal glands (located on top of the kidneys) to produce cortisol,. Cushing disease -- caused by a pituitary gland that produces too much of the hormone ACTH, which then signals the adrenal glands to produce cortisol. Cushing disease, a form of Cushing syndrome, occurs in about 40% of cases and is the most common cause of excess endogenous cortisol production by the adrenal glands. It is caused by a pituitary tumor (adenoma) that secretes ACTH

Treatment of Cushing's Syndrome Guideline Resources

What is Cushing syndrome? Cushing syndrome (also sometimes called Cushing's syndrome) is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time. Cortisol is a steroid hormone produced by the adrenal glands, located above the kidneys. In normal amounts, cortisol helps the body Subclinical Cushing's syndrome: Current concepts and trends George N. Zografos,1 Iraklis Perysinakis,1 Evangeline Vassilatou2 13rd Department of Surgery, General Hospital G. Gennimatas; 2Endocrine Unit, 2 nd Department of Internal Medicine, Attikon University Hospital, Athens, Greece AbSTrAcT clinically inapparent adrenal masses which are incidentally detected have become a commo Cushing syndrome (CS) is a state of glucocorticoid excess in which there is loss of the normal hypothalamic-pituitary-adrenal feedback axis. First described in 1912 by American neurosurgeon Dr Harvey Williams Cushing in reference to a 23-year-old patient with obesity, hirsutism, and amenorrhea, CS has since been recognized as a rare, yet serious. Cushing's syndrome is a rare entity, and a high index of suspicion is needed for screening in a primary care setting. The clinical awareness of the primary care physician (PCP) to the highly indicative signs and symptoms such as facial plethora, proximal myopathy, reddish purple striae, and easy bruisability should alert him to look for biochemical evidence of Cushing's syndrome. The term Cushing's disease is applied to those cases of Cushing's syndrome in which hypercortisolism is secondary to inappropriate secretion of ACTH by the pituitary. Studies on control of ACTH secretion in these patients reveal: (a) that the episodic secretion of ACTH is similar to the normal; howe

Cushing Syndrome. Kelompok 9 Nurul Fadillah Asran C12114313 Dwi Utari C12114001 Karnila C12114320 Rezky C12114030 Fadhilatul Marah C12114004. DEFINISI Sindrom Cushing terjadi akibat aktivitas korteks adrenal yang berlebihan. Sindrom tersebut dapat terjadi akibat pemberian kortikosteroid atau ACTH yang berlebih atau akibat hiperplasia korteks adrenal. PATOFISIOLOGI SINDROM CUSHING a Equine Cushing's Disease Equine Cushing's Disease is a condition of older horses and typically develops in horses over 15 years of age, although it can develop in younger animals. Up to 30% of aged horses have the condition and the risk of developing the disease increases directly with age such that most horse Il est particulièrement utile pour éliminer un syndrome de Cushing devant des signes non spécifiques. - Chez des patients observants, on peut envisager de réaliser en première intention le dosage du CLU. Dans les autres cas, on réservera cette investigation aux patients non répondeurs lors du test de freinage Cushing's syndrome is a rare disorder which can severely affect the patient. Symptoms of patients with Cushing's syndrome include weight gain, easy bruising, menstrual irregularities, increased appetite, trouble sleeping, depression or mood swings, anxiety, fatigue and altered mentation (trouble concentrating or decreased memory) (1-3) Cushing's syndrome, also called hypercortisolism, is a rare endocrine disorder caused by chronic exposure of the body's tissues to excess levels of cortisol - a hormone naturally produced by the adrenal gland.Exposure to too much cortisol can occur from long-term use of synthetic glucocorticoid hormones to treat inflammatory illnesses

syndrome however is the term to describe the condition of excess cortisol in the body which can be due to Cushing's disease or other causes such as long-term use of corticosteroid medication, severe depression, excessive alcohol use or of Cushing's syndrome: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism. 2008;93:1526-40. 12. Newell-Price J, Trainer P, Besser M, Grossman A. The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states. Endocr Rev. 1998;19(5):647-72. 13 Hypercortisolism and Cushing Syndrome. Cushing syndrome is the result of excessive glucocorticoids from either an exogenous or endogenous source. 1 Exogenous (iatrogenic) CS, the most common form, is caused by excessive oral, intra-articular, topical, or inhaled corticosteroids used as anti-inflammatory or immunosuppressive treatments. Because iatrogenic CS is medication dependent, the process. Cushing's disease results when the body produces too much of a hormone called cortisol. Cortisol is produced and stored by the adrenals, two small glands that sit on top of the kidneys Only three biochemical tests — urinary free cortisol, plasma corticotropin, and plasma cortisol measurements — are needed to distinguish patients with Cushing's syndrome from those with.

Cushing's syndrome is a condition caused by prolonged exposure to increased blood levels of glucocorticoid hormones. It can develop through either 1) hormonal overproduction by the adrenal glands or 2) by taking glucocorticoid in medication form Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent.

Hirsutism (androgen excess) warda

Cushings syndrom er en sykdom som skyldes forhøyet konsentrasjon i blodet av hormonet kortisol eller legemidler som inneholder glukokortikoider, såkalt medikamentutløst Cushings syndrom. Ved forhøyet kortisolkonsentrasjon over lengre tid forstyrres omsetningen av fett, protein og karbohydrater, samt forskjellige mineraler (kalsium, natrium, kalium), og organismens evne til å reagere. Cushing disease and Cushing syndrome are two endocrine conditions which take place due to over production of a-fore mentioned Cortisol. Cushing disease is caused by a tumor or an excessive growth in the pituitary gland and the disease is a major cause of the Cushing syndrome. This is the main difference between Cushing disease and Cushing syndrome Overall, Cushing's syndrome is quite uncommon and affects approximately 1 in 50,000 people. Most of them are adults between the ages of 20 and 50. Women are 3 times more commonly affected than men Strictly speaking, if the source of the problem is the pituitary gland, then the correct name is Cushing's disease. Whereas, if it originates anywhere else, then the correct name is Cushing's syndrome. The term 'Cushing's' is used throughout this booklet. Sometimes, the amount of cortisol causing the condition can vary greatly

(PDF) Clinical guidelines: The Endocrine Society of SriCushing Syndrome | Belgium| PDF | PPT| Case Reports(PDF) New diagnostic criteria of adrenal subclinicalCushings Syndrome |authorSTREAM

Cyclic Cushing's syndrome caused by a pituitary adenoma has been reported in up to 19% of patients with ACTH-secreting pituitary tumors in case series. In one study, 36% of patients with Cushing's syndrome of diverse causes showed evidence of cyclic Cushing's syndrome. It is not known why cyclic Cushing's syndrome develops in some patients or Cushing's Syndrome in Dogs (Excessive Levels of Steroids in the Body) Basics OVERVIEW •Spontaneous hyperadrenocorticism (HAC) or Cushing's syndrome is a disorder caused by excessive production of steroids by the adrenal glands; spontaneous denotes lack o Cushing's syndrome (CS) results from prolonged exposure to elevated endogenous cortisol. Majority of cases are caused by ACTH, pituitary, or ectopic origin. Primary adrenal hypersecretion is 15-20% caused by adenomas, carcinomas (ACC), and rarely by nodular adrenocortical disease. CS presents with all typical features

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