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Androgens

Epinephrine,
norepinephrine
Glucocorticoids

Mineralocorticoids
Cushing’s syndrome
Cushing’s syndrome (CS) is composed of symptoms and signs associated
with prolonged exposure to inappro...
Medical Treatment
Metyrapone, an 11β-hydroxylase blocker,
which is given in doses of 750 mg to 4 g
daily in 3–4 divided do...
Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome
- Trans-sphenoidal removal of the tumor
Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome
- External pituitary irradiation
Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome
- Medical therapy to reduce ACTH (e.g.
bromocriptine, cabe...
Bilateral adrenalectomy is an effective last resort if other measures
fail to control the disease. This can be performed l...
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
Cushing syndrome
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Cushing syndrome

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Cushing syndrome

  1. 1. Androgens Epinephrine, norepinephrine Glucocorticoids Mineralocorticoids
  2. 2. Cushing’s syndrome Cushing’s syndrome (CS) is composed of symptoms and signs associated with prolonged exposure to inappropriately high levels of plasma glucocorticoids. - Exogenous glucocorticoid intake is the most common cause of CS. - The endogenous causes are divided into ACTH-dependent and ACTHindependent CS.
  3. 3. Medical Treatment Metyrapone, an 11β-hydroxylase blocker, which is given in doses of 750 mg to 4 g daily in 3–4 divided doses. Ketoconazole (200 mg three times daily) is also used and is synergistic with metyrapone.
  4. 4. Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome - Trans-sphenoidal removal of the tumor
  5. 5. Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome - External pituitary irradiation
  6. 6. Cushing’s disease - ACTH dependent (pituitary) Cushing Syndrome - Medical therapy to reduce ACTH (e.g. bromocriptine, cabergoline, cyproheptadine, somatostatin analogues such as pasireotide) is rarely effective. There is some evidence that aggressive corticotroph adenomas may respond to temozolomide chemotherapy.
  7. 7. Bilateral adrenalectomy is an effective last resort if other measures fail to control the disease. This can be performed laparoscopically.

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