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==Differentiating Cushing's syndrome from Other Diseases==
==Differentiating Cushing's syndrome from Other Diseases==
The table below summarizes the findings that differentiate Cushing's sisease from other conditions that may cause hypertension, hyperandrogenism and obesity. Facial plethora, skin changes, osteoporosis, nephrolithiasis and neuropsychiatric conditions should raise the concern for Cushing's syndrome.<ref name="pmid11253984">{{cite journal |vauthors=Boscaro M, Barzon L, Fallo F, Sonino N |title=Cushing's syndrome |journal=Lancet |volume=357 |issue=9258 |pages=783–91 |year=2001 |pmid=11253984 |doi=10.1016/S0140-6736(00)04172-6 |url=}}</ref><ref name="pmid11571938">{{cite journal |vauthors=Findling JW, Raff H |title=Diagnosis and differential diagnosis of Cushing's syndrome |journal=Endocrinol. Metab. Clin. North Am. |volume=30 |issue=3 |pages=729–47 |year=2001 |pmid=11571938 |doi= |url=}}</ref><ref name="pmid9793762">{{cite journal |vauthors=Newell-Price J, Trainer P, Besser M, Grossman A |title=The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states |journal=Endocr. Rev. |volume=19 |issue=5 |pages=647–72 |year=1998 |pmid=9793762 |doi=10.1210/edrv.19.5.0346 |url=}}</ref>
The table below summarizes the findings that differentiate Cushing's sisease from other conditions that may cause hypertension, hyperandrogenism and obesity. Facial plethora, skin changes, osteoporosis, nephrolithiasis and neuropsychiatric conditions should raise the concern for Cushing's syndrome.<ref name="pmid11253984">{{cite journal |vauthors=Boscaro M, Barzon L, Fallo F, Sonino N |title=Cushing's syndrome |journal=Lancet |volume=357 |issue=9258 |pages=783–91 |year=2001 |pmid=11253984 |doi=10.1016/S0140-6736(00)04172-6 |url=}}</ref><ref name="pmid11571938">{{cite journal |vauthors=Findling JW, Raff H |title=Diagnosis and differential diagnosis of Cushing's syndrome |journal=Endocrinol. Metab. Clin. North Am. |volume=30 |issue=3 |pages=729–47 |year=2001 |pmid=11571938 |doi= |url=}}</ref><ref name="pmid9793762">{{cite journal |vauthors=Newell-Price J, Trainer P, Besser M, Grossman A |title=The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states |journal=Endocr. Rev. |volume=19 |issue=5 |pages=647–72 |year=1998 |pmid=9793762 |doi=10.1210/edrv.19.5.0346 |url=}}</ref><ref name="urlHow Is Metabolic Syndrome Diagnosed? - NHLBI, NIH">{{cite web |url=+https://www.nhlbi.nih.gov/health/health-topics/topics/ms/diagnosis |title=How Is Metabolic Syndrome Diagnosed? - NHLBI, NIH |format= |work= |accessdate=}}</ref>
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{| align="center"
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! style="background:#4479BA; color: #FFFFFF;" |Causes
! style="background:#4479BA; color: #FFFFFF;" |Causes
! style="background:#4479BA; color: #FFFFFF;" |Associated features
! style="background:#4479BA; color: #FFFFFF;" |Associated features
! style="background:#4479BA; color: #FFFFFF;" |Diagnostic approach
! style="background:#4479BA; color: #FFFFFF;" |Diagnostic approach  


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|-
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*Kidney stones
*Kidney stones
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Urinary free cortisol
*Midnight salivary cortisol
*Low dose dexamethasone challenge test
*CRH stimulation
*High dose dexamethasone test
*MRI brain
*CT/MRI adrenals


|-
|-
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*Oligomenorrhea/hypogonadism
*Oligomenorrhea/hypogonadism
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Urinary free cortisol
*Midnight salivary cortisol
*Low dose dexamethasone challenge test
*Glucose tolerance test
*Loperamide test
|-
|-
| align="center" style="background:#DCDCDC;" |[[Metabolic syndrome X]]
| align="center" style="background:#DCDCDC;" |[[Metabolic syndrome X]]
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*Diabetes/Glucose intolerance
*Diabetes/Glucose intolerance
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Waist circumferance
*Low-density lipoproteins
*High-density lipoproteins
*Glucose tolerance test
*Fasting blood sugar
*HbA1c





Revision as of 16:11, 13 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Cushing's syndrome must be differentiated from other diseases that cause hypertension, obesity, and hyperandrogenism, such as Metabolic syndrome X and pseudo-Cushing's sndrome.

Differentiating Cushing's syndrome from Other Diseases

The table below summarizes the findings that differentiate Cushing's sisease from other conditions that may cause hypertension, hyperandrogenism and obesity. Facial plethora, skin changes, osteoporosis, nephrolithiasis and neuropsychiatric conditions should raise the concern for Cushing's syndrome.[1][2][3][4]

Conditions Causes Associated features Diagnostic approach
Cushing's syndrome
  • Iatrogenic
  • Pituitary adenoma
  • Adrenal tumor
  • Adrenal hyperplasia
  • Ectopic ACTH secretion
  • Obesity
  • Hypertenion
  • PCOS/hyperandrogenism
  • Oligomenorrhea/hypogonadism
  • Osteoporosis
  • Myopathy/cutaneous wasting
  • Neuropsychiatric problems
  • Kidney stones
  • Urinary free cortisol
  • Midnight salivary cortisol
  • Low dose dexamethasone challenge test
  • CRH stimulation
  • High dose dexamethasone test
  • MRI brain
  • CT/MRI adrenals
Pseudo-Cushing's syndrome
  • Obesity
  • Alcoholism
  • Depresson
  • HIV
  • Obesity
  • Hypertenion
  • PCOS/hyperandrogenism
  • Oligomenorrhea/hypogonadism
  • Urinary free cortisol
  • Midnight salivary cortisol
  • Low dose dexamethasone challenge test
  • Glucose tolerance test
  • Loperamide test
Metabolic syndrome X
  • Familial/genetic
  • Obesity
  • Insulin resistance
  • Obesity
  • Hypertenion
  • PCOS/hyperandrogenism
  • Oligomenorrhea/hypogonadism
  • Dyslipidemia
  • Diabetes/Glucose intolerance
  • Waist circumferance
  • Low-density lipoproteins
  • High-density lipoproteins
  • Glucose tolerance test
  • Fasting blood sugar
  • HbA1c


References

  1. Boscaro M, Barzon L, Fallo F, Sonino N (2001). "Cushing's syndrome". Lancet. 357 (9258): 783–91. doi:10.1016/S0140-6736(00)04172-6. PMID 11253984.
  2. Findling JW, Raff H (2001). "Diagnosis and differential diagnosis of Cushing's syndrome". Endocrinol. Metab. Clin. North Am. 30 (3): 729–47. PMID 11571938.
  3. Newell-Price J, Trainer P, Besser M, Grossman A (1998). "The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states". Endocr. Rev. 19 (5): 647–72. doi:10.1210/edrv.19.5.0346. PMID 9793762.
  4. [+https://www.nhlbi.nih.gov/health/health-topics/topics/ms/diagnosis "How Is Metabolic Syndrome Diagnosed? - NHLBI, NIH"] Check |url= value (help).


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