Classification

Adrenal Cushing

Pituitary Cushing

Relevant Physiology

Etiology

• Exogenous steroid use → RULE OUT! Oral Corticosteroid (OCS)

Primary

• Mostly iatrogenic
• Adrenal adenoma
• Adrenal carcinoma
• Primary bilateral nodular adrenal cortical disease
  • very rare, onset age: 4 yr, present with sub-clinical Cushing
  • reversable, treat the underlying condition

Secondary

• PIT-NET → Bilateral adrenal hyperplasia (most common)
  • Image sella → image petrosal sinuses
• Ectopic NET (e.g. SCLC, Gastric Cancer → as it is from neuroendocrine cells as well)
  • chest and abdominal CT

Pathogenesis

• Cortisol Effect

Presentation

Signs and Symptoms

• Investigate adrenal causes of ↑High BP if:
• Appearance
• Other Sign & Symptoms

Risk factors

Investigation

Management