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Cushing's syndrome: all variants, detection, and treatment

Susmeeta T Sharma1, Lynnette K Nieman

  • 1Program on Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Building 10, CRC, 1East, Room 3140, 10 Center Drive, Bethesda, MD 20892-1109, USA.

Endocrinology and Metabolism Clinics of North America
|May 14, 2011
PubMed

Insights

Diagnosing Cushing's syndrome and its causes, like glucocorticoid-induced hypertension, requires a careful approach. Optimal treatment involves surgical removal of the cause, with medications used as supplementary therapies.

Area of Science:

  • Endocrinology
  • Internal Medicine

Background:

  • Cushing's syndrome diagnosis is complex.
  • Glucocorticoid-induced hypertension has multiple proposed causes.
  • Cortisol's vascular effects contribute to hypertension.

Purpose of the Study:

  • To outline the diagnostic challenges of Cushing's syndrome.
  • To review pathogenic mechanisms of glucocorticoid-induced hypertension.
  • To discuss optimal treatment strategies for Cushing's syndrome.

Main Methods:

  • Step-wise diagnostic approach for Cushing's syndrome.
  • Review of proposed pathogenic mechanisms for hypertension.
  • Evaluation of surgical and pharmacological treatment options.

Main Results:

  • Establishing the cause of Cushing's syndrome can be difficult.
  • Mechanisms include mineralocorticoid excess, renin-angiotensin system (RAS) upregulation, and cortisol's vascular damage.
  • Surgical excision is the primary treatment.

Conclusions:

  • Surgical excision of the causative factor is the preferred treatment for Cushing's syndrome.
  • Pharmacological agents serve as adjunctive therapies.
  • Medical management is crucial for surgical preparation and non-surgical candidates.

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