Cushing's syndrome: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Cutaneous: easy bruising, friable, striae, [[rash|hyperpigmentation]] | *Cardiac: [[Hypertension]] | ||
*Cutaneous: easy bruising, friable, striae, [[rash|hyperpigmentation]], poor wound healing | |||
*Endocrine | *Endocrine | ||
**Androgen excess causing hirsutism, oily skin, increased libido | **Androgen excess causing hirsutism, amenorrhea, oily skin, increased libido | ||
**[[hyperglycemia|Glucose intolerance]] | **[[hyperglycemia|Glucose intolerance]] | ||
**Obesity | |||
*Metabolic: progressive [[The Obese Patient|obesity]] (esp. buffalo hump and supraclavicular fat pads obscuring clavicles) | *Metabolic: progressive [[The Obese Patient|obesity]] (esp. buffalo hump and supraclavicular fat pads obscuring clavicles) | ||
* | *Musculoskeletal: proximal muscle atrophy, [[weakness]], osteoporosis | ||
*Ophthalmologic: cataracts, increased [[intraocular pressure]] | *Ophthalmologic: cataracts, increased [[intraocular pressure]] | ||
*Psychologic: emotional lability, depression, irritability, anxiety, panic attacks, mild paranoia and mania | *Psychologic: emotional lability, depression, irritability, anxiety, panic attacks, mild paranoia and mania | ||
Revision as of 14:35, 10 February 2021
Background
- Hypercortisolism producing an array of non-specific symptoms
- Exclude exogenous glucocorticoids and pregnancy
Clinical Features
- Cardiac: Hypertension
- Cutaneous: easy bruising, friable, striae, hyperpigmentation, poor wound healing
- Endocrine
- Androgen excess causing hirsutism, amenorrhea, oily skin, increased libido
- Glucose intolerance
- Obesity
- Metabolic: progressive obesity (esp. buffalo hump and supraclavicular fat pads obscuring clavicles)
- Musculoskeletal: proximal muscle atrophy, weakness, osteoporosis
- Ophthalmologic: cataracts, increased intraocular pressure
- Psychologic: emotional lability, depression, irritability, anxiety, panic attacks, mild paranoia and mania
Differential Diagnosis
Evaluation
- Outpatient: 24h urinary free cortisol or dexamethasone suppression test
Management
- Treat complications (e.g. hyperglycemia) as appropriate
- Typically outpatient/non-ED management
Disposition
- Typically discharge
References
UpToDate