CushingSyndrome.ppt

HYPERCORTISOLISM CUSHING SYNDROME Contents What is Cushing syndrome? What is the causes? How to diagnose? Clinical Features Hormone levels Functional test Localization How to treatment? Contents What is Cushing syndrome? What is the causes? How to diagnose? Clinical Features Hormone levels Functional test Localization How to treatment? Definition Cushing Syndrome A diverse symptom complex resulting from excess steroid hormone (cortisol) production Cushing Disease A hypercortisolism resulting from pituitary ACTH hypersecretion Contents What is Cushing syndrome? What is the causes? How to diagnose? Clinical Features Hormone levels Functional test Localization How to treatment? Capsula Glomerulosa Fasciculata Reticularis Medulla Aldosterone Androgen Catecholamine Adrenal Structure Cortisol Cortisol Secretion Regulation ACTH CRH Cortisol Hypothalamus Pituitary Adrenal Causes of Cushing Syndrome ACTH CRH Cortisol Hypothalamus Pituitary Adrenal Ectopic CRH syndrome Hypothalamus Cushing syn. Cushing disease (CD) Ectopic ACTH syndrome Adrenal adenoma Adrenal carcinoma Micronodular adrenal disease Massive macronodular adrenal disease Causes of Cushing syndrome 1. Endogenous Cushing syndrome (1) ACTH-dependent Cushing disease (CD) Ectopic ACTH syndrome Ectopic CRH syndrome (2) ACTH-independent Adrenal adenoma Adrenal carcinoma Micronodular adrenal disease Massive macronodular adrenal disease (3) Pseudocushing syndrome 2. Exogenous Cushing syndrome Contents What is Cushing syndrome? What is the causes? How to diagnose? Clinical Features Hormone levels Functional test Localization How to treatment? Function Clinical Features Functions Clinical Features Fat Central obesity, “moon face” “buffalo hump” Protein Thin extremities, muscle weakness,