Overview

• Syndrome associated with chronic inappropriate elevations of free circulating cortisol
• ACTH Dependent (80%) → excess ACTH from pituitary adenoma (Cushing's Disease) (most common endogenous cause) or ectopic ACTH (Small Cell Lung Cancer)
• ACTH Independent (20%) → Adrenal adenoma or Adrenal carcinoma
• F>M, peak incidence 20-40 yrs old
• Risk Factors → exogenous corticosteroid use (most common cause overall), pituitary or adrenal adenoma, or adrenal carcinoma
• ACTH Dependent v Independent

Making Diagnosis

Clinical Features:

• Thin, easily bruisable skin with ecchymoses
• Stretch marks (striae)
• Proximal Myopathy (Muscle Weakness)
• Central Adiposity
• Fatigue
• Hirsutism
• Acne
• Hyperpigmentation (if ACTH dependent)