A ratio >2.0 for the baseline inferior petrosal sinus to the peripheral ACTH concentration or a ratio >3.0 after administration of ACTH-releasing hormone is consistent with pituitary-dependent
Cushing syndrome.
Measurement of 24-h urinary free cortisol (UFC) provides the most sensitive and specific diagnostic information for adrenal malfunctions, especially for
Cushing syndrome [1, 2].
Initially described in earlier part of the 20th century by surgeon Harvey Cushing,
Cushing syndrome is a complex endocrine disorder characterized by excess levels of serum cortisol.1,2 It can occur secondary to multiple etiologies broadly classified as exogenous (iatrogenic) or endogenous (spontaneous).3 Endogenous
Cushing Syndrome may occur secondary to primary adrenal hyper function however the most common etiology is the elevated ACTH levels which leads to adrenal hyper function and increased serum cortisol levels.4,5 Most common source of elevated ACTH levels is the pituitary adenoma in which case the complex is labeled as Cushing disease while in approximately 20% cases the source of elevated ACTH is ectopic.
Nested stromal epithelial tumor of the liver: six cases of a distinctive pediatric neoplasm with frequent calcifications and association with
cushing syndrome. Am J Surg Pathol.
Patients with hirsutism due to etiologies other than PCOS like idiopathic hirsutism,
Cushing syndrome or late-onset congenital adrenal hyperplasia were excluded.
Cushing syndrome is a group of symptoms caused by too much cortisol in the body.
Hypercortisolism in endogenous
Cushing syndrome (CS) [6] is a condition associated with poor quality of life and high morbidity that if left untreated carries a median survival of <5 years (1).
Serri, "Iatrogenic
cushing syndrome in patients receiving inhaled budesonide and itraconazole or ritonavir: Two cases and literature review," Endocrine Practice, vol.
Lodish, "Incidence of autoimmune and related disorders after resolution of endogenous
Cushing syndrome in children," Hormone and Metabolic Research, vol.
Cushing disease is a relatively rare cause of
Cushing syndrome secondary to a hyperfunctioning pituitary adenoma.
The excess Cortisol found in
Cushing syndrome can result from certain steroid medications or from tumors of the pituitary or adrenal glands.
Adrenal venous sampling in a patient with adrenal
Cushing syndrome. Colomb Med 2015; 46:84-87.