Surf Wiki
Save to docs
general/syndromes

From Surf Wiki (app.surf) — the open knowledge base

Pseudo-Cushing's syndrome

FieldValue
namePseudo-Cushing's syndrome
fieldEndocrinology

Pseudo-Cushing's syndrome or non-neoplastic hypercortisolism is a medical condition in which patients display the signs, symptoms, and abnormal cortisol levels seen in Cushing's syndrome. However, pseudo-Cushing's syndrome is not caused by a problem with the hypothalamic-pituitary-adrenal axis as Cushing's is: it is mainly an idiopathic condition, though a cushingoid appearance is sometimes linked to excessive alcohol consumption. Elevated levels of total cortisol can also be due to estrogen found in oral contraceptive pills that contain a mixture of estrogen and progesterone. Estrogen can cause an increase of cortisol-binding globulin and thereby cause the total cortisol level to be elevated.

Signs and symptoms

Diagnosis

  • Levels of cortisol and ACTH both elevated
  • 24-hour urinary cortisol levels elevated
  • Dexamethasone suppression test
  • Late night salivary cortisol (LNSC)
  • Loss of diurnal variation in cortisol levels (seen only in true Cushing's Syndrome)
  • High mean corpuscular volume and gamma-glutamyl transferase may be clues to alcoholism
  • Polycystic Ovarian Syndrome should be ruled out; PCOS may have similar symptoms

Differential diagnosis

  • Differentiation from Cushing's is difficult, but several tools exist to aid in the diagnosis
  • Alternative causes of Cushing's should be excluded with imaging of lungs, adrenal glands, and pituitary gland; these often appear normal in Cushing's
  • In the alcoholic patient with pseudo-Cushing's, admission to hospital (and avoidance of alcohol) will result in normal midnight cortisol levels within five days, excluding Cushing's
  • Another cause for Cushing's syndrome is adrenocortical carcinoma. This is a rare form of cancer with an incidence of 1-2 per million people annually. About 60% of these cancers produce hormones, with cortisol being the most frequent. Most patients present in an advanced disease state and the outcome is dismal.

Prognosis

  • Blood results and symptoms normalise rapidly on cessation of drinking or remission of depression.

References

tags--

References

  1. (2005). "Kumar and Clark clinical medicine". Elsevier Saunders.
  2. C. W. Burke. (1969). "The effect of oral contraceptives on cortisol metabolism". Journal of Clinical Pathology.
  3. (November 2007). "Reevaluation of the combined dexamethasone suppression-corticotropin-releasing hormone test for differentiation of mild cushing's disease from pseudo-Cushing's syndrome". Journal of Clinical Endocrinology and Metabolism.
  4. (January 2020). "Approach to patients with pseudo-Cushing's states". Endocrine Connections.
  5. (2007). "Diagnostic approach to Cushing disease". Neurosurgical Focus.
  6. (1998). "The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states.". Endocrine Reviews.
  7. (2006). "Adrenocortical Carcinoma: Clinical Update". Journal of Clinical Endocrinology and Metabolism.
Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

syndromes endocrine-diseases
Want to explore this topic further?

Ask Mako anything about Pseudo-Cushing's syndrome — get instant answers, deeper analysis, and related topics.

Research with Mako

Free with your Surf account

Content sourced from Wikipedia, available under CC BY-SA 4.0.

This content may have been generated or modified by AI. CloudSurf Software LLC is not responsible for the accuracy, completeness, or reliability of AI-generated content. Always verify important information from primary sources.

Report