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Related Concept Videos

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...
Cushing Syndrome II: Pathophysiology01:19

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...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

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A Novel Method: Super-selective Adrenal Venous Sampling
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Cushing's syndrome.

Betul A Hatipoglu1

  • 1Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. hatipob@ccf.org

Journal of Surgical Oncology
|June 29, 2012
PubMed
Summary

Cushing's syndrome (CS) is caused by excess cortisol exposure, often from ACTH-dependent sources or primary adrenal issues like tumors. Diagnosis involves specific tests and imaging, with lifelong follow-up essential for managing this complex endocrine disorder.

Area of Science:

  • Endocrinology
  • Internal Medicine
  • Oncology

Background:

  • Cushing's syndrome (CS) arises from prolonged endogenous cortisol overexposure.
  • Most cases stem from ACTH-dependent sources (pituitary, ectopic).
  • Primary adrenal hypersecretion accounts for 15-20%, often due to adenomas or adrenal cortical carcinoma (ACC).

Purpose of the Study:

  • To summarize the etiology, clinical presentation, diagnostic approaches, and management challenges of Cushing's syndrome.
  • To highlight the importance of accurate diagnosis and ongoing patient follow-up.

Main Methods:

  • Review of common diagnostic tests including urinary free cortisol, late-night salivary cortisol, and dexamethasone suppression test (DST).
  • Emphasis on the critical role of imaging in diagnosis.

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  • Discussion of challenges in CS management.

    • Main Results:

    • CS presents with characteristic clinical features.
    • Initial diagnostic testing aids in identifying hypercortisolism.
    • Imaging modalities are crucial for localizing the source of cortisol excess.

    Conclusions:

    • Cushing's syndrome diagnosis and treatment remain challenging.
    • Accurate diagnostic workup is essential.
    • Lifelong patient follow-up is mandatory for effective management of CS.