Cushing's syndrome classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Furqan M M. M.B.B.S[3]
Overview
Cushing's syndrome may be classified according to the source of cortisol into four subtypes; Endogenous, exogenous, familial Cushing's Syndrome, and pseudo-Cushing’s syndrome.
Classification
Cushing's syndrome is classified into two main subtypes:[1][2][3]
- Exogenous:
- Also called iatrogenic Cushing's syndrome. It is due to chronic glucocorticoid intake for inflammatory conditions, such as allergies, asthma, autoimmune diseases, and after organ transplantation.
- Endogenous:
-
- Pituitary adenoma
- Adrenal adenoma
- Adrenal micronodular hyperplasia
- Ectopic adenomas, which are originated from locations other than the pituitary or adrenal glands, mostly from the lungs, pancreas, thyroid, or thymus.
- Malignant tumors:
- Adrenal cancer
- Cancer in places other than the pituitary or adrenal glands, mostly in the lungs, pancreas, thyroid, or thymus
-
- Familial Cushing's Syndrome:
- Patients with rare genetic diseases like multiple endocrine neoplasia type 1 (MEN 1) and primary pigmented micronodular adrenal disease are more susceptible to develop tumors in glands that affect cortisol secretion. As a result, these patients will develop Cushing's syndrome.
- Pseudo-Cushing’s Syndrome:
- It is due to alcoholism, depression or other psychiatric disorders, obesity, pregnancy, and poorly controlled diabetes.
References
- ↑ Lacroix A, Feelders RA, Stratakis CA, Nieman LK (2015). "Cushing's syndrome". Lancet. 386 (9996): 913–27. doi:10.1016/S0140-6736(14)61375-1. PMID 26004339.
- ↑ Raff H, Carroll T (2015). "Cushing's syndrome: from physiological principles to diagnosis and clinical care". J. Physiol. (Lond.). 593 (3): 493–506. doi:10.1113/jphysiol.2014.282871. PMC 4324701. PMID 25480800.
- ↑ Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD (2014). "Adrenocortical carcinoma". Endocr. Rev. 35 (2): 282–326. doi:10.1210/er.2013-1029. PMC 3963263. PMID 24423978.