Cushing's syndrome classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
There are two types of Cushing’s syndrome: exogenous and endogenous. In endogenous disease, excess cortisol production within the body is the cause, whilst in exogenous disease the causal factor is typically steroid medication (i.e. it originates outside the body) mimicing cortisol's activity. The signs and symptoms are therefore virtually identical, aside from those induced by ACTH in pituitary-dependent disease and ectopic ACTH-producing tumours (such as hyperpigmentation). The exogenous route is by far the most commonly taken in Cushing’s syndrome (a fact that all too many seem to forget). Examples of such exogenous steroid medications are those used to treat inflammatory disorders such as asthma and rheumatoid arthritis, or to suppress the immune system after an organ transplant. This type of Cushing’s syndrome is temporary and goes away after the patient has finished taking the cortisol-like medications. Endogenous Cushing’s syndrome is unusual, it usually comes on slowly and can be difficult to diagnose.