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HISTORYCompany Logo1932: Harvey Cushing described a series of
seven pts with basophilic adenomas of the pituitary ---
CD19122014Over 100 yearsRare cases or rare found?
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DEFINITIONChronic glucocorticoid excesswhatever its causes, is
accompanied by a wide range of signs and symptoms known asCompany
LogoCushings syndromeBoscaro M, Arnaldi G. Approach to The Patient
With Paossible Cushings Syndrome. Journal of Clinical Endocrinology
and Metabolism. 2009 ; 3121-3131
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EPIDEMIOLOGYCompany Logo
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Company LogoCLASSIFICATION Cushings disease ACTH pituitary
adenoma Ectopik ACRH secretion Adrenal adenoma Adrenal carcinoma
Bilateral adrenal hyperplasia Iatrogenic Caushings Syndrome
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www.themegallery.comCompany LogoADRENAL
STEROIDOGENESISPREGNENOLONE17-HYDROXIL
PREGNENOLONDHEADHEASANDROSTENEDION11-DEOXYCORTISOLTESTOSTERONPROGESTERONCORTICOSTERON17-OHPDEOXYCORTICOSTERONECORTISOLCORTISONECHOLESTEROLHSD11B1
HSD11B2ALDOSTERON
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www.themegallery.comCompany LogoETIOLOGYACTH-dependent
Pituitary (CD) (70%)Microadenomas (95%)Macroadenomas (5%)
Ectopic ACTH or CRH (10%)Small cell lung caCarcinoids: lung,
pancreas, thymus
ACTH-independent(Factitious)UnilateralAdrenal adenoma
(10%)Adrenal carcinoma (5%)
BilateralMacronodular Hyperplasia (AIMAH) (
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PATHOPHYSIOLOGYwww.themegallery.comCompany Logo
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CLINICAL MANIFESTATIONwww.themegallery.comCompany Logo
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- www.themegallery.comCompany LogoSURGICAL TEATMENT FOR CAUSHINGS
SYNDROMEDone by neurosurgeons Remission rate of 80-90%Cure is
confirmed by demonstrating profound hypoadrenalism post-op (am
cortisol
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17OHP= 17
HIDROXYPREGENOLONEDHEA=DIHIDROEPIANDOSTERONDHEAS=SULFATE*
