MedClips

Causes Cushing's syndrome is a syndrome characterized by hypertension, fatigability, weakness, sexual dysfunction, striae, edema, osteoporosis, and truncal obesity of chronic glucocorticoid (cortisol). Cushing's syndrome is the cause of exogenous origin of cushing's syndrome caused by drugs such as glucocorticoid. The next is cushing's syndrome of endogenous origin. ACUT-dependent pituitary adenoma, cushing's disease, is a microadenoma of less than 10 mm mostly over 90%. It may also be caused by ectopic ACTH secretion. This may be caused by SCLC, thymoma, pancreatic islet cell tumor, MTC, and pheochromocytoma, which induces hypersecretion of ACTH at the origin, not the pituitary gland. ACTH independent causes are adrenal neoplasm and adrenal nodular hyperplasia. Adrenal neoplasm is usually unilateral, 8-10% of adenoma, and 8-10% of carcinoma. Therefore, it must be distinguished, and if it is uncertain as to the imaging test, postoperative biopsy is essential. It i...

Diagnosis The diagnosis of Cushing's syndrome begins with identifying and abolishing the history of the disease, such as when taking herbal medicines, taking steroids, or injecting intra-articular steroids. There were three screening tests: the first one was overnight 1 mg dexamethasone suppression test, and the first one was dexamethasone 1 mg at 11 o'clock the night before, and the next day at 8 o'clock, plasma cortisol was measured at 1.8 ug / dL Or more. This test is called pseudo-cushing's syndrome, which is very likely to be false, because it is very diverse, including obesity, depression, alcoholism, acute infection / trauma, and pregnancy. Re-measurement after removal and supplementation to other tests are necessary. The second is a 24hr urinary for cortisol excretion test, which is positive if the urine collected from the urine collected for 24 hours is higher than normal or the concentration is increased more than 3 times. The third screening test is positiv...