Hypercortisolism (Cushing’s Syndrome)

Abstract

Cushing's syndrome may be originated by different causes that are divided into ACTH-dependent or ACTH-independent. Central obesity is the most common sign, and hypertension, impaired glucose metabolism, menstrual irregularities, and osteoporosis are also frequently observed. These features are related to an adverse cardiovascular risk profile and to cardiovascular disease, that is the major cause of morbidity and death in patients with Cushing's syndrome. Biochemical diagnosis is mandatory to confirm glucocorticoid excess and the absence of physiological suppression of cortisol with dexamethasone tests. ACTH measurement is the first test that must be performed in order to establish the etiological diagnosis, and distinguish between ACTH-dependent or independent Cushing's syndrome. Surgical treatment of adrenal adenoma or hyperplasia via a laparoscopic procedure is preferred in adrenal Cushing's syndrome.