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
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.
is a group of symptoms caused by too much cortisol in the body.
Hypercortisolism in endogenous Cushing syndrome
(CS)  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.