Endocrinology
Cushing Syndrome
쿠싱증후군
Cortisol excess (endogenous or exogenous)
- How common
- Common in endocrinology
- Typical age
- Variable age
What is it?
Core hormonal/metabolic pathophysiology of Cushing Syndrome.
Commonly affected: Endocrine gland + target tissues
How it develops
- Genetic/environmental factorTriggering factor for Cushing Syndrome
- Hormonal changeSpecific hormone excess or deficiency
- Target organ effectAffects metabolism, CV, nerves, bone
- Symptoms + complicationsCharacteristic features and long-term complications
Symptoms
- Hormone-driven featuresClassic Cushing Syndrome features
- Metabolic/weight changeWeight, appetite, energy changes
- Associated complicationsCV, neuro, bone complications
How it is examined
- Hormonal assaysRelevant hormones + stim/suppress tests
- Imaging if indicatedThyroid US, adrenal CT, pituitary MRI
Imaging
Mostly lab diagnosis; X-ray usually unnecessary.
- Lab findings
Thyroid US, pituitary MRI, adrenal CT as indicated.
- Adenoma/nodule
- Target organ change
Non-surgical care
- Hormone replacement or suppressionReplace if deficient, suppress if excess
- Lifestyle + dietWeight, exercise, dietary control
- Manage comorbiditiesHTN, DM, osteoporosis, etc.
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Tumor, medical failure, complications
Procedures that may be discussed
- Adenoma resection
- Radioactive iodine if applicable
- Endocrine gland excision
Outlook
Good with early diagnosis and active management.