Depression is the most prevalent psychiatric disturbance in Cushing's syndrome. A major depressive syndrome is seen in 50%-70% of the cases [ 2 ]. Other associated features include anxiety in 12%-79% of the cases [ 3 ], as well as a rate of 3% for hypomania [ 4 ]. Less common are features of psychosis and mania [ 5, 6 ] Cushing's syndrome may present with various psychiatric disorders which can lead to a misdiagnosis at the beginning, deterioration of the course of the disease and life-threatening complications. The most common psychiatric disorder is atypical depression. During the initial stages of the disease, the somatic symptoms of Cushing's syndrome. Cushing's disease often causes psychiatric symptoms. The most common are cognitive impairment, irritability, anxiety, and depression. Psychotic disorders and delusions are less common, but also occur Over the past few decades, a number of authors have found a significant amount of psychological disorders associated with Cushing's syndrome. Sonino and Fava found that major depression is a life-threatening complication, which may affect 50-60% of patients with Cushing's syndrome
Endogenous Cushing's syndrome (CS), a rare endocrine disorder characterized by cortisol hypersecretion, is associated with psychiatric and neurocognitive disorders. Major depression, mania, anxiety, and neurocognitive impairment are the most important clinical abnormalities. Moreover, patients most Endogenous Cushing's syndrome (CS), a rare endocrine disorder characterized by cortisol hypersecretion, is associated with psychiatric and neurocognitive disorders. Major depression, mania, anxiety, and neurocognitive impairment are the most important clinical abnormalities
Psychiatric complications of Cushing's syndrome include irritability, anxiety, depressed mood, and cognitive impairment, while psychosis is a rare manifestation ment including disorder of memory is aconsistent and prominent clinical featureof patients with Cushing's syndrome.It is of interest that a syndrome soclearly organic in etiology has many fea-tures associated with primary depressivedisorder. This may suggest the presenceof similarities in the pathophysiology ofCushing's syndrome and depressive dis-orders Major psychiatric disturbances other than mood and anxiety disorders are infrequent in Cushing's syndrome, and if psychotic symptoms occur, they are likely to be a complication of mania or severe depression. Focusing on pituitary-dependent Cushing's disease, Sonino et al. found DSM-IV major depression in 88 (54%) of their 162 patients Endogenous Cushing's syndrome (CS), a rare endocrine disorder characterized by cortisol hypersecretion, is associated with psychiatric and neurocognitive disorders. quent and severe psychiatric disorder associated with chronic endogenous hypercortisolism. The prevalence of major depres-sion in patients with CS is reported to be about 50.
Mental health issues such as anxiety, depression, sleep disturbances, and cognitive impairments are part of the wide range of symptoms caused by the abnormally high levels of the cortisol hormone that characterize Cushing's syndrome. Of note, Cushing's disease is a form of Cushing's syndrome caused by a tumor in the pituitary gland. A. Up to 85% of patients with Cushing's syndrome present with mental changes and psychiatric symptoms, most commonly disturbances of affect24, 52, 59, 69, 71, 119, 121 and anxiety disorders, including generalized anxiety disorder and panic disorder. 79 Although relatively rare, psychotic disorders have been reported to occur. 70 Psychiatric. Endogenous Cushing's syndrome (CS) is associated with significant psychopathology during the course of the disease. The purpose of this study was to evaluate the psychological and endocrine status of patients with CS after correction of their hypercortisolism
Dorn conducted research on Cushing's syndrome and depression in conjuction with Dr. George Chrousos, MD, who is the Chief of Pediatric Endocrinology at NIH in Bethesda, MD. This research was published in Clinical Endocrinology, Volume 43, pp. 433-442, 1995 Find the training resources you need for all your activities. Studyres contains millions of educational documents, questions and answers, notes about the course, tutoring questions, cards and course recommendations that will help you learn and learn
Auto-immune and inflammatory disorders in Cushing's syndrome. June 23, 2015. From Lewis S Blevins Jr, MD - I've seen a few instances over my career of auto-immune and inflammatory disorders flaring or becoming more apparent after someone has entered remission for Cushing's syndrome. In each circumstance, there were no prior indicators. Cushing syndrome can cause a range of symptoms. 1,2 The symptoms might also be similar to those of other conditions. 3. Physically, someone with Cushing syndrome might: Be heavy or obese above the waist but have thin arms and legs; Have a round, red face, sometimes referred to as a moon fac In particular, mood disorders, especially depression, are common in patients with Cushing's disease. In a study of 209 subjects with Cushing's syndrome, there was a history of significant psychiatric illness, usually depression, which preceded the onset of signs and symptoms of Cushing's syndrome in up to 12% of subjects . In this study.
. Complications Associated with Cushing's Syndrome. Beyond the normal symptoms associated with Cushing's syndrome, certain complications or other medical conditions may occur as a result. Cushing's disease is a rare disorder, affecting adults between the ages of 20 and 50.. Cushing's Disease Stresses Your Heart and Your Mental Health. Adults with Cushing's disease, also called hypercortisolism, have a three-fold higher risk of dying from heart disease compared to the general population, 1 says Oskar Ragnarsson, MD, PhD, associate professor in internal medicine and endocrinology at Sahlgrenska University Hospital. Another problem associated with hyperactivity of the hypothalamus-pituitary adrenal axis is the presentation of psychiatric diseases, such as mood disorders, usually depression. However, manic symptoms are not common at the onset of Cushing's syndrome Cushing disease is a term given specifically to Cushing syndrome caused by overstimulation of the adrenal glands, usually because of a pituitary tumor. In this disorder, the adrenal glands are overactive because the pituitary gland is overstimulating them, and not because the adrenal glands are abnormal. Symptoms of Cushing disease are similar.
In the management of Cushing syndrome, it is crucial to treat comorbidities such as diabetes mellitus, hypertension, osteoporosis, psychiatric issues, and electrolyte disorders. Cushing syndrome due to an ACTH tumor that cannot be resected entirely may require bilateral adrenalectomy followed by lifelong adrenal glucocorticoid replacement (e.g. Common signs and symptoms of Cushing syndrome. Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump) Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms. Thinning, fragile skin that bruises easily Glucocorticoids are crucial in the initiation and consolidation of the stress response. Patients with active Cushing's syndrome (CS) are exposed to excessive endogenous glucocorticoid levels. In these patients, psychopathology is often being observed. The most common co-morbid disorder is major depression, but to a lesser extent mania and anxiety disorders have also been reported The relationship of depressed mood and hormone levels was examined. Low ACTH levels were significantly associated with milder rather than pronounced depressed mood. The implications of the similarities in psychiatric manifestations between Cushing's syndrome and the primary affective disorders are discussed Cushing's syndrome or hypercortisolism, occurs due to abnormally high levels of the hormone cortisol. This can happen for a variety of reasons. In most cases, getting treatment can help you.
Cushing's syndrome is the collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly Cushing's syndrome can be caused by a tumor of the pituitary gland, a tumor of the adrenal gland, a tumor somewhere other than the pituitary or adrenal glands (ectopic Cushing's syndrome), or by long-term use of corticosteroids (drugs commonly used to treat conditions such as rheumatoid arthritis and asthma) Cushing's Syndrome, also known as hypercortisolism, is an endocrine disorder characterized by an excess of cortisol. In the absence of prescribed steroid medications, it is caused by a tumor on the pituitary or adrenal glands, or more rarely, an ectopic hormone-secreting tumor Cushing's Syndrome occurs when the body's tissues are exposed to high levels of cortisol for too long. Many people develop Cushing's syndrome because they take glucocorticoids-steroid hormones that are chemically similar to naturally produced cortisol-such as prednisone for asthma, rheumatoid arthritis, lupus, and other inflammatory diseases been identified or if cyclical Cushing's syndrome is suspected. ** Conditions associated with hypercortisolism include diabetes mellitus, severe obesity, alcoholism, late pregnancy, psychiatric disorders, physical stress, malnutrition, intense chronic exercise, hypothalamic amenorrhoea and corticosteroid binding protein excess
Cushing's syndrome (CS) denotes various causes of endogenous overproduction of glucocorticoids that may be due to cortisol hypersecretion by a pituitary adenoma, an adrenal tumor or a neuroendocrine tumor (1, 2). It represents a severe medical condition that preferentially affects women of childbearing age (3, 4). This is why, despite. Cushing's syndrome is a rare disease. Cushing's syndrome presenting as acute psychosis is an exceptional occurrence. We present the case of a 37-year-old woman who was admitted with acute confusion associated with mild hypercalcaemia and was subsequently diagnosed with parathyroid and adrenal adenomas. Our hospital sees approximately 6000 endocrine patients per year, with an incidence of.
The syndrome is associated with an increased risk of developing psychiatric disorders such as depression, resulting in reduced quality of life. Conversely, long-term psychiatric illnesses can promote metabolic syndrome: its prevalence is 2-3 times higher in people with severe psychiatric illnesses ( Reference Holt, Abdelrahman and Hirsch Holt. Cushing's syndrome was discovered by the American neurosurgeon Harvey cushing in 1932. Cushing's described a metabolic disorder characterized by truncal obesity, hypertension, fatigability and weakness, amenorrhea, diabetes mellitus, hirsutism, purplish abdominal striae, edema, glucosuria, osteoporosis and a basophilic tumor of the. What are psychiatric disorders? The DSM-5 definition a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental function In Cushing's disease, the 24-hour urine free cortisol (UFC) levels are typically at least four to five times greater than normal. Your doctor may need two or more elevated 24-hour UFC tests to confirm the diagnose Cushing's syndrome. Uncommonly, Cushing's disease can come and go (periodic Cushing's disease), requiring multiple 24-hour UFC tests Marfan syndrome is an inherited disorder that affects connective tissue — the fibers that support and anchor your organs and other structures in your body. Marfan syndrome most commonly affects the heart, eyes, blood vessels and skeleton. People with Marfan syndrome are usually tall and thin with unusually long arms, legs, fingers and toes
Cushing's syndrome is a metabolic disorder that has several possible causes. In this case it is caused by excessive production of cortisol by a tumor of an adrenal gland. Cushing's syndrome is caused by constant, high levels of cortisol, a key glucocorticoid hormone. The growth of a tumor on one of the two adrenal glands causes about 15% of all. The cases with neurodevelopmental or psychiatric disorders were identified from the HILMO, defined as a primary or secondary diagnosis: F30-39 and F92 (mood disorders), F40-43 and F93 (anxiety disorders), F50 (eating disorders), F51 (sleeping disorders), F60-69 (personality disorders), F70-79 (intellectual disabilities), F80-83. Cushing's syndrome or hypercortisolism is a disorder characterized by features resulting from chronic exposure to excess glucocorticoids. Cushing's syndrome may be exogenous, due to chronic glucocorticoid intake, or endogenous, due to increased adrenal secretion of cortisol or adrenocorticotropic hormone (ACTH) production from the pituitary gland or ectopic sources Corcept is studying relacorilant in a variety of serious disorders, including Cushing's syndrome and adrenal, ovarian and pancreatic cancer. oncologic and psychiatric disorders by modulating. Cushing syndrome is a constellation of clinical abnormalities caused by chronic high blood levels of cortisol or related corticosteroids.Cushing disease is Cushing syndrome that results from excess pituitary production of adrenocorticotropic hormone (ACTH), generally secondary to a pituitary adenoma. Typical symptoms and signs include moon face and truncal obesity, easy bruising, and thin arms.
Diabetes in adolescents is associated with a threefold increased risk of psychiatric disorders, as high as 33% , primarily major depression (28%)  and anxiety disorder (18%)  Cushing's syndrome can also cause changes to your skin, bones, muscles and mood. Skin changes: thin skin that bruises easily, slow-healing cuts or an increase in face and body hair in women. Bone and muscle changes: osteoporosis (thin and weak bones) and muscle weakness, especially in your upper legs and arms Cushing's syndrome is a disease caused by increased production of cortisol or by excessive use of cortisol or other steroid hormones. Causes, incidence, and risk factors Cushing's syndrome is a condition that results from an excess of cortisol, a hormone produced by the adrenal glands
Cushing's syndrome is a general term for increased secretion of cortisol by the adrenal cortex. When corticosteroids are administered externally, a condition of hypercortisolism called iatrogenic Cushing's syndrome occurs. When the hypercortisolism results from an oversecretion of ACTH from the pituitary, the condition is called Cushing's. The incidence of Cushing syndrome in humans is 10 to 15 for every 1,000,000 people (McCance & Huether, 2014). In most cases, Cushing syndrome occurs in individuals aged between 20 to 50 years. Additionally, Cushing syndrome has been found to be more prevalent in females compared to males. There are various risk factors associated with Cushing. . Another name for Cushing's syndrome is hypercortisolism. Some people have Cushing's syndrome symptoms when they take glucocorticoid hormones to treat inflammatory conditions such as asthma, lupus or rheumatoid arthritis Pediatric autoimmune neuropsychiatric disorders associated with group A b-hemolytic streptococcal infections can be associated with the onset or exacerbation of tics and/or obsessive-compulsive symptoms; compared with controls, patients with Tourette syndrome are more likely to have had a streptococcal infection 3 months before symptom onset. What are the six clinical findings associated with cushings syndrome? (1) Rapid weight gain/inability to lose weight (2) Moon facies (3) Dorsocervical fat pad (Buffalo hump) (4) Hirsutism and irregular menses in women (5) Glucose intolerance/type 2 diabetes (6) Low bone mineral density/osteoporosis
Factitious Cushing's syndrome is exceptionally rare. The diagnosis is challenging due to the interference of exogenous corticosteroids with cortisol immunoassays. We present a case of a 26 year old female that presented with clinical and biochemical features of Cushing's syndrome. She denied any exogenous corticosteroid use. She had a suppressed ACTH level with normal adrenal glands on CT scans Because Cushing's syndrome causes aldosterone overproduction, which increases urinary potassium loss, the disorder may lead to hypokalemia. Therefore, the nurse should immediately report signs and symptoms of hypokalemia, such as an irregular apical pulse, to the physician
What is Cushings Syndrome? Named after Henry Cushing, an American neurosurgeon who pointed out the condition in 1912, this is a syndrome that is caused by long-term exposure to excessive levels of cortisol.Cortisol is a hormone made by the adrenal glands, located right on top of the kidneys. You may have heard of cortisol before during discussions of obesity 1. Introduction Cushing's syndrome (CS) is a rare disease due a cortisol excess. Its symptoms include facial plethora, muscle weakness, skin symptoms (red or purple striae and easybruising), bone loss, cardiovascular risk factors (hypertension, diabetes and impaired glucose tolerance, dyslipidemia, coagulopathy, and central obesity), fatigue, lack of libido, emotional lability, depression.
Age at diagnosis of Cushing's syndrome was 8-74 (mean 39) years. Duration of symptoms was 0.2-9 (median 2.0) years. Adverse life events within the 2 years preceding the onset of Cushing's syndrome were not significantly commoner than in controls. Depressive illnesses were associated with the presence of adverse life events (p < 0.001) When Cushing's syndrome was diagnosed, significant psychiatric illness, usually depression, was present or had been a feature of Cushing's syndrome in 120 (57%) patients. CRF LHPA Stress Options Pregnancy Prednisone 21st century Ketoconazole Mood disorders Stressed tree shrews Glucocorticoids and mood Alcohol, suicide and serotoni In considering the mental states associated with Cushing's syndrome, the fifth and fourth categories of relationship, as made above, are of obvious importance. The social consequences of this syndrome in any patient are tremendous, butparticularly so in females. Obstinate hirsuties, adiposity, an cognitive abnormalities are also observed in Cushing's syndrome . The rates for each of these symptoms vary widely across studies. Depression is the most prevalent psychiatric disturbance in Cushing's syndrome. A major depressive syndrome is seen in 50%-70% of the cases . Other associated features include anxiety in 12%-79% o
In addition to intellectual and developmental disabilities, children with Down syndrome are at an increased risk for certain health problems. However, each individual with Down syndrome is different, and not every person will have serious health problems. Many of these associated conditions can be treated with medication, surgery, or other interventions Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings | BMC Psychiatry | Full Text - 04 July 2016. It looks like we inherit not only chronic physical pain but also a fourfold increased risk of both anxiety and depression.. Somehow, it makes sense to me that having a body too loose and.
General Information: Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Sometimes called hypercortisolism, Cushing's syndrome occurs when the body's tissues are exposed to high levels of cortisol for too long. (1) Many people develop Cushing's syndrome because they take glucocorticoids—steroid. Cushing's syndrome is a serious endocrine disease caused by chronic, autonomous, and excessive secretion of cortisol. The syndrome is associated with increased mortality and impaired quality of life because of the occurrence of comorbidities. These clinical complications include metabolic syndrome, consisting of systemic arterial hypertension, visceral obesity, impairment of glucose metabolism. Diogenes Syndrome is more commonly referred to as simply hoarding, and is one of the most misunderstood mental disorders. Named after the Greek philosopher Diogenes of Sinope (who was, ironically, a minimalist), this syndrome is usually characterized by the overwhelming desire to collect seemingly random items, to which an emotional. Cushing's syndrome is a rare condition that is the result of too much of the hormone cortisol in the body. Cortisol is a hormone normally made by the adrenal glands and it is necessary for life. It allows people to respond to stressful situations such as illness, and has effects on almost all body tissues. It is produced in bursts, most in.
Future lines of research should further explore the psychological issues associated with JHS/hEDS to define the nature of a relationship. Introduction. The relationship between Joint Hypermobility Syndrome/hypermobile type Ehlers-Danlos syndrome (JHS/hEDS) and anxiety was an unexpected finding that we first described in 1988 at the Hospital del. + 1.0 Treatment goals for Cushing's syndrome 1.1 In patients with overt Cushing's syndrome (CS), we recommend normalizing cortisol levels or action at its receptors to eliminate the signs and symptoms of CS and treating comorbidities associated with hypercortisolism . Early diagnosis may mitigate against this natural history of the disorder. The clinical presentation of Cushing's syndrome varies, in part related to the extent and duration of cortisol excess
. Cushing's disease is associated with weight gain, muscle weakness, bone loss and fatigue, which exercise is great for reducing naturally Cushing's syndrome is a disorder that occurs when your body makes too much of the hormone cortisol over a long period of time. Cortisol is sometimes called the stress hormone because it helps your body respond to stress. Cortisol also helps. maintain blood pressure. regulate blood glucose, also called blood sugar. reduce inflammation Factitious Disorder and Fabricated Mental Health Complaints . The second category of factitious complaints and issues are mental health. This can be estimated at 40% of the total factitious complaints (Yates 2016). Alcohol abuse. Hallucinations. Suicidal and homicidal ideation. PTSD (made up traumas) Bereavement . Childhood sexual abus
Introduction to Cushing Syndrome and Cushing Disease. Hypercortisolemia is the hallmark symptom in both Cushing disease and Cushing syndrome. Cushing syndrome is the disorder first described by Harvey Cushing in 1932 in several patients with adrenocortical hyperplasia that were the result of basophilic adenomas of the anterior pituitary Cushing syndrome is a rare disorder caused by having high levels of cortisol over a long time. It's caused by a tumor on the pituitary gland or adrenal gland, or taking some kinds of medicine. Cushing syndrome may cause excess weight, slow growth, and problems with sexual development. Treatment may include medicines or surgery Since Cushing's syndrome has a propensity to progress and severe hypercortisolism is believed to be associated with worse outcomes, early recognition and treatment is of critical importance. As previously discussed, many patients with Cushing's syndrome will have coexistent systemic disorders such as glucose intolerance, hypertension, and. Miscellaneous Symptoms of Cushing's Syndrome. A host of other symptoms are associated with Cushing's syndrome. Fatigue and weakness are common, as is the deterioration of cognitive capabilities.Females with Cushing's syndrome may have uncharacteristically unpredictable and irregular menstrual cycles, even to the point of having no period for several months Patients in the above photos were diagnosed with hypercortisolism/Cushing syndrome. Some photographs from: Cushing H. Clinical manifestations of disordered function. In: The Pituitary Body and Its Disorders: Clinical States Produced by Disorders of the Hypophysis Cerebri. Philadelphia, PA: JB Lippincott Company; 1912
The higher the index, the higher the likelihood of a diagnosis of Cushing's syndrome being correct. On the basis of a study of 159 people, signs that have the best discriminatory value are easy bruising (62% of cases, discriminant index 10.3), objective muscle weakness (56%, 8.0), plethora (94%, 3.0), and purple striae (56%, 2.5). 9 Absence. Cushing's syndrome is a disorder characterized by abnormally high levels of cortisol, a hormone that plays a central role in the body's response to stress. High cortisol levels — or hypercortisolism — can be driven by tumors in the adrenal glands, which sit on top of the kidneys, or in the pituitary gland, a small pea-size master gland. Cushing's syndrome is excessive glucocorticoid secretion resulting in sodium and water retention. Diabetes mellitus is a hyperglycemic state marked by polyuria, polydipsia, and polyphagia. Adrenal crisis is undersecretion of glucocorticoids resulting in profound hypoglycemia, hypovolemia, and hypotension. Question 5 Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections (PANDAS) is a neurological and psychiatric condition in which symptoms are brought on or worsened by a Streptococcal (strep) infection.PANDAS is a subtype of pediatric acute-onset neuropsychiatric syndrome (PANS).Signs and symptoms of PANDAS align with current guidelines for diagnosing PANDAS, and include Pituitary Disorders. There are many diseases associated with the pituitary gland. The Pituitary Society provides detailed information on these illnesses. Acromegaly Cushing's Syndrome and Cushing's Disease Adult Growth Hormone Deficiency Hypopituitarism Non-functioning Tumors Prolactinoma Gamma Knife Radiation Therapy for Pituitary Tumors
Psychosomatic aspects of Cushing's syndrome. Rev Endocr Metab Disord. A number of psychiatric and psychological disturbances may be associated with the active hypercortisolemic state, regardless of its etiology. Within the high frequency of mood disorders (about 60%), major depression is the most common complication Lab Testing for Cushing Syndrome. The signs and symptoms of Cushing Syndrome are the results of cortisol levels that are abnormally high, which is referred to as hypercortisolism. Cortisol is a steroidal hormone that is produced by the cortex, which is the outer layer of the adrenal gland. The break-down of fat Cushing syndrome is a condition associated with a constellation of signs and symptoms caused by prolonged exposure to high levels of glucocorticoids. psychiatric symptoms, Occult Cushing's syndrome seen in up to 5.5% of overweight or obese, type 2 diabetic patients. Rating:. Cushing's syndrome is a disorder of the endocrine system. Cushing's syndrome (Cushing's disease, Hypercortisolism, Adrenal Hyperfunction) is a cluster of clinical abnormalities caused by excessive levels of adrenocortical hormones (particularly cortisol) or related corticosteroids and, to a lesser extent, androgens and aldosterone
Cushing syndrome (also sometimes called Cushing's syndrome) is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time. Cortisol is a steroid hormone produced by the adrenal glands, located above the kidneys. In normal amounts, cortisol helps the body Cushing syndrome: ( kush'ing ), a disorder resulting from increased adrenocortical secretion of cortisol (giving clinical picture of Cushing disease ), due to any one of several sources: ACTH-dependent adrenocortical hyperplasia or tumor, ectopic ACTH-secreting tumor, or excessive administrations of steroids; characterized by trunkal obesity,.
The most common cause of Cushing's syndrome is the use of exogenous glucocorticoids (e.g. prednisolone, hydrocortisone). Endogenous. Endogenous Cushing's syndrome can be further sub-categorised as either corticotropin-dependent or corticotropin-independent. Corticotropin-dependent Cushing's syndrome accounts for 80-85% of cases. Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day. Healthcare professionals use the guidelines in The American Psychiatric Association's Diagnostic and Statistical Manual, Fifth edition (DSM-5) 1 , to. The Cushing's Syndrome GUIDELINES Pocket Guide is based on the latest guidelines of The Endocrine Society and was developed with their collaboration. This practical quick-reference tool contains evidence-graded treatment recommendations for all phases of Cushing's Syndrome, a treatment algorithm and a table of drugs with pros, cons and doses If Cushing's syndrome is a result of a pituitary tumor, a transsphe-noidal hypophysectomy may be performed. Dia-betes mellitus and peptic ulcer are common in the patient with Cushing's syndrome. Therefore, insulin therapy and medication to treat peptic ulcer may be initiated if needed