Cushing's disease
| Incidental findings | RA, scratch marks (PBC) |
| +ve signs | Bruising, central obesity, moon-like facies, abdominal striae, proximal myopathy. |
| Differential diagnosis | Cushings syndrome/disease |
| Function | |
| Tests |
U&e, glucose 24h urinary free cortisol Low dose dexamethasome supression – failure of supression High dose dexamethasome supression – supresses with pit but not adrenal/ectopic Plasma ACTH±MR pit fossa ±Inferior petrosal sinus sampling |
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Extensions
- Proximal myopathy: Stand from chair, stand from squatting
- Visual fields
- Fundus: hypertension, optic atrophy, papilloedema
Causes
Exogenous steroids
Pituitary adenoma ‘Cushing’s disease’
Adrenal adenoma
Adrenal carcinoma
Ectopic ACTH (e.g. small cell ca lung)
Exogenous steroids
Pituitary adenoma ‘Cushing’s disease’
Adrenal adenoma
Adrenal carcinoma
Ectopic ACTH (e.g. small cell ca lung)