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Psychiatric Manifestations Of Cushing’s Syndrome

Peter T. Loosen
Published 2002 · Medicine
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The constellation of clinical signs and symptoms that we now call “Cushing’s syndrome” was first described by Cushing in 1932. Cushing’s syndrome results from chronic exposure to excessive concentrations of glucocorticoids. The physical features of Cushing’s syndrome include weight gain, central obesity (i.e., accumulation of adipose tissue in the facial, nuchal, truncal and girdle areas), facial plethora, hirsutism, cutaneous striae, muscle wasting, weakness, and osteoporosis. Other common manifestations of hypercortisolemia include hypertension, glucose intolerance or diabetes mellitus, impotence and testicular atrophy, amenorrhea, mild erythrocytosis, lymphopenia, eosinopenia and frequent fungal infections. Cushing’s syndrome can be divided into two major categories, each of which has two major causes. ACTH-dependent Cushing’s syndrome can be caused by excessive ACTH secretion by a pituitary microadenoma (referred to as “Cushing’s disease”) or by ACTH secretion by a non-pituitary tumor (“ectopic ACTH syndrome”), usually a small cell carcinoma of the lung or a bronchial, thymic or pancreatic carcinoid tumor, which together account for 75% of all cases. ACTH-independent Cushing’s syndrome is caused by adrenocortical tumors that secrete cortisol autonomously or by administration of pharmacologic doses of synthetic glucocorticoids.

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