Cushing’s syndrome is a disorder characterised by symptoms and signs of chronic excessive tissue exposure to glucocorticoids. It is a rare disease and the incidence is estimated to be 2 to 10 patients per million populations per year.
Exogenous exposure to glucocorticoids accounts for most of the cases. Among the endogenous causes of Cushing’s syndrome, Cushing’s disease is the most common followed by adrenal adenomas and carcinomas, ectopic ACTH syndrome and nodular adrenal hyperplasia.
Cushing’s disease is most often caused by pituitary corticotroph microadenoma (90%), and macroadenomas account only for about 5-10%. Syndromes associated with Cushing’s disease include Multiple endocrine neoplasia 1 (MEN1), Carney complex, McCune Albright syndrome (MAS), familial isolated pituitary adenoma syndrome and rarely Multiple endocrine neoplasia 2A (MEN2A).
Author(s) Details:
Santosh B
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Raman Boddula
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Ashok Venkatanarasu
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Aditya Hegde
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Chimutai Chinte
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Vidya Tickoo
Department of Endocrinology, Yashoda Hospital, Secunderabad, Telangana, India.
Recent Global Research Developments in Overview of Cushing Syndrome: Key Insights from StatPearls
Key Insights from StatPearls
StatPearls provides a comprehensive overview of Cushing Syndrome, highlighting its pathophysiology, diagnosis, and management. Key points include:
- Pathophysiology: Cushing Syndrome is characterized by prolonged exposure to high levels of cortisol. It can be endogenous (due to adrenal or pituitary tumors) or exogenous (due to prolonged use of corticosteroids).
- Diagnosis: Diagnostic methods include 24-hour urinary free cortisol test, late-night salivary cortisol test, and low-dose dexamethasone suppression test.
- Management: Treatment options vary based on the underlying cause and may include surgery, radiation, and medications to control cortisol production.
Recent Journal Articles
Global Epidemiology of Cushing’s Disease:
A systematic review and meta-analysis found that the prevalence of Cushing’s Disease is approximately 2.2 per 100,000 people, with an incidence rate of 0.24 per 100,000 person-years [1] . The study emphasizes the need for large-scale epidemiological studies and standardized diagnostic criteria.
Mortality Risks in Cushing’s Syndrome:
A large-scale analysis revealed that Cushing’s Syndrome triples the risk of death, primarily due to cardiovascular diseases and infections [2] . The study highlights the importance of early diagnosis and effective management to reduce mortality rates.
Medical Management of Cushing’s Syndrome:
This review discusses current and emerging medical treatments for Cushing’s Syndrome, including the efficacy and safety of novel drugs [3] . It also explores future potential targets for therapy.
Clinical Trials on Cushing’s Disease:
An overview of ongoing and recently completed clinical trials provides insights into new therapeutic approaches for Cushing’s Disease[4] . The review summarizes preliminary data and definitive reports from scientific literature.
Advances in Surgical Techniques:
Recent advancements in surgical techniques for treating Cushing’s Syndrome have improved patient outcomes. Minimally invasive procedures and improved postoperative care have contributed to lower complication rates and better recovery [1] .
References
- Giuffrida, G., Crisafulli, S., Ferraù, F. et al. Global Cushing’s disease epidemiology: a systematic review and meta-analysis of observational studies. J Endocrinol Invest 45, 1235–1246 (2022). https://doi.org/10.1007/s40618-022-01754-1
- Largest-ever analysis of its kind finds Cushing’s syndrome triples risk of death
- https://www.endocrine.org/news-and-advocacy/news-room/featured-science-from-endo-2021/largest-ever-analysis-of-its-kind-finds-cushings-syndrome-triples-risk-of-death
- Hinojosa-Amaya, J.M., Cuevas-Ramos, D. & Fleseriu, M. Medical Management of Cushing’s Syndrome: Current and Emerging Treatments. Drugs 79, 935–956 (2019). https://doi.org/10.1007/s40265-019-01128-7
- Pivonello R, Ferrigno R, De Martino MC, Simeoli C, Di Paola N, Pivonello C, Barba L, Negri M, De Angelis C and Colao A (2020) Medical Treatment of Cushing’s Disease: An Overview of the Current and Recent Clinical Trials. Front. Endocrinol. 11:648. doi: 10.3389/fendo.2020.00648
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