Cushing's+Syndrome

//Western Diagnosis// excess of cortisol - clinical abnormalities from chronic exposure

Etiology
1. hypersecretion of ACTH by pituitary 2. secretion of ACTH by a non-pituitary tumor 3. administration of exogenous ACTH

Signs & Symptoms
1. rounded moon facies with a plethoric appearance 2. truncal obesity 3. dorsal cervical fat pads (buffalo hump) 4. supraclavicular fat pads 5. slender distal extremities and fingers 6. muscle wasting and weakness 7. thin atrophic skin 8. easy bruising, poor wound healing 9. purple striae on abdomen 10. hypertension 11. glucose intolerance (DM) 12. renal calculi 13. osteoporosis 14. reduced resistance to infection 15. mental disturbances 16. virilism in the female

Laboratory
1. elevated plasma cortisol with no diurnal variation 2. elevated free urinary cortisol 3. plasma ACTH 4. dexamethasone test 5. many other tests

Treatment
1. surgery of pituitary or adrenals 2. irradiation of pituitary 3. adrenalectomy 4. drugs as adrenal inhibitors or inhibitors to cortisol