Cushing's syndrome differential diagnosis

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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]

Conditions Causes Associated features
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
Metabolic syndrome X
  • Familial/genetic
  • Obesity
  • Insulin resistance
  • Obesity
  • Hypertenion
  • PCOS/hyperandrogenism
  • Oligomenorrhea/hypogonadism
  • Dyslipidemia
  • Diabetes/Glucose intolerance
Pseudo-Cushing's syndrome
  • Obesity
  • Alcoholism
  • Depresson
  • HIV
  • Obesity
  • Hypertenion
  • PCOS/hyperandrogenism
  • Oligomenorrhea/hypogonadism

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.


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