KULIA H P R E K L I NIK 2020

Cushing
Syndrome

Divisi Endokrin, Metabolik, Diabetes - Ilmu Penyakit Dalam FK USU

 Cushing
Harvey Willams Cushing

Syndrome
BACKGROUND

Named after Harvey Williams Cushing in

1912.

DESCRIBED AS
Endocrine disorder with elevated cortisol
level in the blood.
 Normal Anatomy of Human
Hypothalamic- Pituitary Unit
Normal negative feedback regulation
of Cortisol and Aldosterone secretion
 Cortisol
Glucocorticoid not soluble in water --> 95% bind to globulin.
5% is free --> biologically active

Cortisol level peak in the morning

Levels drop in the evening

Signs and
symptoms?
- Hypertension
- Impaired glucose tolerance or type 2 diabetes
- Osteopenia or osteoporosis with
pathological vertebral compression fractures
- Hyperpigmentation of the skin and mucous membranes
- Manic-depressive psychosis, depression, emotional
debility, 
- Secondary amenorrhea, decreased sexual dynamic
- Leukocytosis, lymphopenia, eosinopenia, frequent
infections.
Diagnosis
Classification of Cushing
Syndrome
ACTH-dependent causes
-Cushing disease
-Ectopic ACTH syndrome
-Ectopic corticotropin-releasing hormone syndrome
-Macronodular adrenal hyperplasia

ACTH-independent causes
-Cortisol-secreting adrenal adenoma and carcinoma
- Primary pigmented nodular adrenal hyperplasia and carney syndrome
- McCune-Albright syndrome
- Macronodular hyperplasia
- Iatrogenic cushing syndrome
Treatment
Thank You!