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Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
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Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
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Related Experiment Video

Updated: Jul 10, 2026

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

Cyclic Cushing syndrome: definitions and treatment implications.

Dennis A Velez1, Marc R Mayberg, William H Ludlam

  • 1Seattle Neuroendocrine Program, Swedish Neuroscience Institute, Seattle, Washington, USA.

Neurosurgical Focus
|October 27, 2007
PubMed
Summary

Cyclic Cushing syndrome (CS) involves fluctuating cortisol levels, complicating diagnosis due to intermittent symptoms and normal hormone levels between episodes. This review defines cyclic CS, explores its causes, and discusses management strategies.

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Last Updated: Jul 10, 2026

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05:56

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Published on: August 29, 2025

Area of Science:

  • Endocrinology
  • Oncology
  • Internal Medicine

Background:

  • Endogenous Cushing syndrome (CS) is caused by excess cortisol production from pituitary adenomas, ectopic tumors, or adrenal tumors.
  • Diagnosis is typically based on clinical signs and laboratory findings of hypercortisolism.
  • However, some patients present with cyclic or intermittent hypercortisolism, leading to complex and varied symptoms.

Purpose of the Study:

  • To define cyclic Cushing syndrome.
  • To review the causes and pathophysiological mechanisms of cyclic CS.
  • To discuss current treatment options for cyclic CS based on literature review.

Main Methods:

  • Literature review of studies on cyclic Cushing syndrome.
  • Analysis of diagnostic challenges in intermittent hypercortisolism.
  • Synthesis of information on causes, mechanisms, and treatments.

Main Results:

  • Cyclic CS presents with fluctuating cortisol levels, making diagnosis difficult.
  • The hypothalamic-pituitary-adrenal axis may appear normal between hypercortisolemic episodes.
  • Dexamethasone suppression testing can yield paradoxical responses in these patients.

Conclusions:

  • Cyclic Cushing syndrome is a distinct entity characterized by intermittent hypercortisolism.
  • Accurate diagnosis requires awareness of cyclic patterns and potential testing anomalies.
  • Further research into pathophysiology and standardized treatment protocols is warranted.