Cushing´s syndrome: Clinical presentation and associated comorbidities

Area of Science:

• Endocrinology
• Internal Medicine
• Clinical Science

Background:

• Cushing's syndrome (CS) results from chronic glucocorticoid excess, manifesting in various clinical signs.
• The presentation and progression of CS differ based on its cause, such as Cushing's disease or ectopic ACTH secretion.
• Age and sex significantly influence the clinical expression and associated comorbidities of CS.

Purpose of the Study:

• To synthesize evidence on Cushing's syndrome, focusing on diagnostic red flags and multisystem complications.
• To link the underlying pathophysiology of hypercortisolism to its diverse health consequences.
• To provide practical guidance for screening and initial management in high-risk populations.

Main Methods:

• Review and synthesis of contemporary evidence on Cushing's syndrome.
• Analysis of phenotypic variations based on etiology, age, and sex.
• Identification of key clinical features, comorbidities, and management strategies.

Main Results:

• CS hallmarks include central obesity, skin changes, proximal myopathy, and various systemic complications.
• Etiology dictates presentation: Cushing's disease is insidious, ectopic ACTH is abrupt, and adrenal forms vary in severity.
• Comorbidities encompass hypertension, diabetes, dyslipidemia, osteoporosis, infections, and neuropsychiatric issues.

Conclusions:

• Recognizing red-flag symptoms can shorten the diagnostic timeline for Cushing's syndrome.
• Understanding the link between hypercortisolism and multisystem complications is crucial for patient care.
• Targeted screening and management strategies are essential to mitigate the long-term health burden of CS.