Cushing's Syndrome

Cushing's syndrome is caused by prolonged exposure to elevated levels of either endogenous or exogenous glucocorticoids. Patients may have increased adipose tissue in the face ('moon face'), upper back at the base of neck ('buffalo hump'), and above the clavicles (supraclavicular fat pads. Violaceous striae, usually more than 1 cm in width, are observed most commonly over the abdomen, buttocks, lower back, upper thighs, upper arms, and breasts . Hypertension may be present. Patients with Cushingoid features may present to the emergency department in adrenal crisis. Two common screening tests for Cushing's syndrome are the 24-hour UFC test and the overnight (ON) 1-mg dexamethasone suppression test: Treatment of Cushing's syndrome is directed by the primary cause of the syndrome.


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