B, Santosh and Boddula, Raman and Venkatanarasu, Ashok and Hegde, Aditya and Chinte, Chimutai and Tickoo, Vidya (2024) Understanding the Symptoms and Signs of Endogenous Cushing Syndrome: A Spectrum of Cases. In: New Visions in Medicine and Medical Science Vol. 5. B P International, pp. 38-47. ISBN 978-81-972413-3-8
Full text not available from this repository.Abstract
Introduction: Cushing’s syndrome (CS) is a rare disorder characterised by symptoms and signs of chronic excessive tissue exposure to glucocorticoids, and is associated with high morbidity and mortality if untreated. A few common features of CS include truncal obesity, moon facies, increased fat in dorsocervical area, ecchymoses, plethora, striae, proximal muscle weakness, thin skin, pigmentation of the skin, osteopenia/ osteoporosis with fractures, avascular necrosis of bone, mood changes, hypertension, impairment of glucose tolerance or worsening of glycemic control, susceptibility to infections, edema, deep vein thrombosis/ pulmonary thromboembolism. The excess cortisol state can result from a number of etiologies- both exogenous and endogenous. It can present with varied and non-specific clinical features. Hence, having a high clinical suspicion is important and it can be challenging to arrive at an exact diagnosis, which is very important to initiate appropriate treatment. Here, we present a spectrum of endogenous Cushing’s syndrome of different etiologies, which are presented to us at different age groups and with different clinical features.
Description of Cases: The main aim of this article is to understand the different symptoms and signs with which the patients with Endogenous Cushing’s syndrome present, the knowledge required to suspect it even in a non-typical presentation, the extensive and laborious work-up done at arriving the diagnosis and localizing the cause, and then finally initiating appropriate treatment. We randomly chose 8 cases of Endogenous Cushing’s syndrome of different presentation and etiology, who presented to our Hospital. We had patients whose ages ranged from 13 years to 60 years; patients presenting with typical features of Cushing’s syndrome to non-specific features and even being asymptomatic. All the cases underwent appropriate and elaborate work-up to arrive at a diagnosis and also to localize the exact lesion. They then underwent appropriate treatment either in the form of surgery (excision of the lesion responsible for the cortisol excess) or medical therapy. The outcome of the patients was good in 6 of these patients, they achieved remission during follow-up. However, 2 patients, one with Adrenocortical carcinoma and another with Ectopic adreno-cortical tropic hormone (ACTH) syndrome due to Poorly differentiated adenocarcinoma of the left lung, died due to the severity of underlying diseases.
Conclusion: Endogenous Cushing’s syndrome, though rare, is associated with high morbidity and mortality if untreated. A high degree of suspicion and a good clinical examination are required to diagnose Cushing’s syndrome, especially in non-florid cases and those with nonspecific features. A systematic, orderly evaluation is required to establish the correct diagnosis and to localize the cause, which will help in the planning of appropriate treatment.
Item Type: | Book Section |
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Subjects: | Asian STM > Medical Science |
Depositing User: | Managing Editor |
Date Deposited: | 22 Apr 2024 04:54 |
Last Modified: | 22 Apr 2024 04:54 |
URI: | http://journal.send2sub.com/id/eprint/3245 |