Cushing's syndrome differential diagnosis: Difference between revisions
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{{CMG}} {{AE}} {{MMF}} | {{CMG}} {{AE}} {{MMF}} | ||
==Overview== | ==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 | Cushing's syndrome must be differentiated from other diseases that cause [[hypertension]], [[obesity]], and [[hyperandrogenism]], such as [[Metabolic syndrome X]] and pseudo-Cushing's syndrome. | ||
==Differentiating Cushing's syndrome from Other Diseases== | ==Differentiating Cushing's syndrome from Other Diseases== | ||
The table below summarizes the findings that differentiate Cushing's | The table below summarizes the findings that differentiate Cushing's disease from other conditions that may cause [[Hypertension|hypertensio]]<nowiki/>n, [[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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*Ectopic ACTH secretion | *Ectopic ACTH secretion | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
* Obesity | * [[Obesity]] | ||
* | *[[Hypertension]] | ||
*PCOS/hyperandrogenism | *[[PCOS]]/[[hyperandrogenism]] | ||
*Oligomenorrhea/hypogonadism | *[[Oligomenorrhea]]/[[hypogonadism]] | ||
*Osteoporosis | *[[Osteoporosis]] | ||
*Myopathy/cutaneous wasting | *[[Myopathy]]/cutaneous wasting | ||
*Neuropsychiatric problems | *Neuropsychiatric problems | ||
*Kidney stones | *[[Kidney stone|Kidney stones]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
*24 hour urine cortisol | *24-hour urine cortisol | ||
*Midnight salivary cortisol | *Midnight salivary cortisol | ||
*Low dose dexamethasone challenge test | *Low dose dexamethasone challenge test | ||
| Line 50: | Line 50: | ||
*Obesity | *Obesity | ||
*Alcoholism | *Alcoholism | ||
* | *Depression | ||
*HIV | *HIV | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
* Obesity | * [[Obesity]] | ||
* | *[[Hypertension]] | ||
*PCOS/hyperandrogenism | *[[PCOS]]/[[hyperandrogenism]] | ||
*Oligomenorrhea/hypogonadism | *[[Oligomenorrhea]]/[[hypogonadism]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
*Urinary free cortisol | *Urinary free cortisol | ||
*Midnight salivary cortisol | *Midnight salivary cortisol | ||
*Low dose dexamethasone challenge test | *Low dose dexamethasone challenge test | ||
*Glucose tolerance test | *[[Glucose tolerance test]] | ||
*Loperamide test | *Loperamide test | ||
|- | |- | ||
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*Insulin resistance | *Insulin resistance | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
* Obesity | * [[Obesity]] | ||
* | *[[Hypertension]] | ||
*PCOS/hyperandrogenism | *[[PCOS]]/[[hyperandrogenism]] | ||
*Oligomenorrhea/hypogonadism | *[[Oligomenorrhea]]/[[hypogonadism]] | ||
*Dyslipidemia | *[[Dyslipidemia]] | ||
*Diabetes/Glucose intolerance | *[[Diabetes mellitus|Diabetes]]/[[Glucose intolerance]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | ||
*Waist | *Waist circumference | ||
*Low-density lipoproteins | *[[Lipoproteins|Low-density lipoproteins]] | ||
*High-density lipoproteins | *[[Lipoproteins|High-density lipoproteins]] | ||
*Glucose tolerance test | *[[Glucose tolerance test]] | ||
*Fasting blood sugar | *[[Fasting blood sugar]] | ||
*HbA1c | *[[HbA1c]] | ||
|} | |} | ||
Revision as of 13:41, 14 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 syndrome.
Differentiating Cushing's syndrome from Other Diseases
The table below summarizes the findings that differentiate Cushing's disease 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]
References
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