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Review
. 2012 Jun 18:7:41.
doi: 10.1186/1750-1172-7-41.

Cushing's disease

Frederic Castinetti  1 , Isabelle Morange, Bernard Conte-Devolx, Thierry Brue
Affiliations
Review

Cushing's disease

Frederic Castinetti et al. Orphanet J Rare Dis. .

Abstract

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 transsphenoidal surgery, which cures 80% of ACTH-secreting microadenomas. The rate of remission is lower in macroadenomas. Other therapeutic modalities including anticortisolic drugs, radiation techniques or bilateral adrenalectomy will thus be necessary to avoid long-term risks (metabolic syndrome, osteoporosis, cardiovascular disease) of hypercortisolism. This review summarizes potential pathophysiological mechanisms, diagnostic approaches, and therapies.

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Figures

Figure 1
Figure 1
Steps necessary to confirm the diagnosis of Cushing’s syndrome.
Figure 2
Figure 2
Steps necessary for the etiological diagnosis of ACTH-dependent Cushing’s syndrome.
See this image and copyright information in PMC

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