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Related Concept Videos

Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

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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...
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Cushing Syndrome II: Pathophysiology01:19

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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...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Related Experiment Video

Updated: Apr 18, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
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Screening for Cushing's syndrome: is it worthwhile?

Ilan Shimon1

  • 1Rabin Medical Center, Institute of Endocrinology and Metabolism, Beilinson Hospital, 49100, Petach Tikva, Israel, ilanshi@clalit.org.il.

Pituitary
|January 13, 2015
PubMed
Summary

Screening for Cushing's syndrome (CS) is recommended for specific patient groups, including those with resistant diabetes mellitus and hypertension. Routine screening is not advised for all patients with morbid obesity or type 2 diabetes.

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Area of Science:

  • Endocrinology
  • Internal Medicine

Background:

  • Cushing's syndrome (CS) presents with diverse symptoms, some overlapping with common conditions.
  • Early identification of milder CS cases is increasing.
  • Screening for CS is often prompted by symptoms like weight gain, diabetes mellitus, hypertension, and osteoporosis.

Purpose of the Study:

  • To review the diagnostic approaches for Cushing's syndrome.
  • To evaluate the utility of screening tests in various patient populations.

Main Methods:

  • This review article focuses on studies utilizing the 1-mg dexamethasone suppression test as a primary screening tool.
  • Analysis of cited literature on screening test performance in diverse clinical contexts.

Main Results:

  • Routine screening for CS is not cost-effective in patients with morbid obesity and type 2 diabetes mellitus.
  • Only 1% of hypertensive patients have secondary hypertension due to CS.
  • Screening is beneficial for young patients with resistant diabetes mellitus and/or hypertension.

Conclusions:

  • Subclinical hypercortisolism is found in up to 5% of patients with osteoporosis and vertebral fractures, often linked to adrenal adenomas.
  • Screening for CS is crucial in individuals with adrenal incidentalomas, with a high prevalence (~10%) of CS or subclinical CS observed.