Cushing’s Syndrome

Disease of cortisol excess, which may be:

Epidemiology and Risk Factors

Pathophysiology

  • Glucocorticoids stimulate fluid retention
  • Renin release

Aetiology

May be:

  • Primary
    • Adrenal hyperplasia
    • Adrenal carcinoma
    • Exogenous secreting tumour
    • Exogenous steroids
      Most common.
  • Secondary
    • Excessive pituitary ACTH secretion

Clinical Manifestations

History

Examination

Diagnostic Approach and DDx

Investigations

Management

Anaesthetic Considerations

  • B
    • Obesity
  • C
    • Hypertension
  • E
    • Muscular wasting
    • Truncal obesity
  • F
    • Renal dysfunction
    • Electrolytes
      Classically ↑ Na+, ↓ K+, ↑ BSL.

Marginal and Ineffective Therapies

Complications

Prognosis

Key Studies


References