Cushing's syndrome natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Cushing's disease can lead to [[Diabetes mellitus|diabetes]], [[cardiovascular]] and [[Psychiatric|psychiatric complications]]. The prognosis depends on the severity of the disease. | Cushing's disease can lead to The symptoms of Cushing's syndrome usually start with symptoms such as rapid [[obesity|weight gain]], a [[round face]] often referred to as a "[[moon face]]", and [[insomnia]]. It may progress to develop [[amenorrhoea]], [[infertility]] and [[Psychological|psychological disturbances]]. If left untreated, patients with Cushing's syndrome may progress to develop [[Diabetes mellitus|diabetes]], [[cardiovascular]] and [[Psychiatric|psychiatric complications]]. The prognosis depends on the severity of the disease. | ||
==Natural History== | |||
The symptoms of Cushing's syndrome usually start with symptoms such as rapid [[obesity|weight gain]], a [[round face]] often referred to as a "[[moon face]]", and [[insomnia]]. It may progress to develop [[amenorrhoea]], [[infertility|infertility,]] and [[Psychological|psychological disturbances]]. If left untreated, patients with Cushing's syndrome may progress to develop [[diabetes mellitus]] and [[cardiovascular]] complications. | |||
==Complications== | ==Complications== | ||
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* [[Insulin resistance]] (especially common in [[Ectopic ACTH Syndrome|ectopic ACTH production]]) | * [[Insulin resistance]] (especially common in [[Ectopic ACTH Syndrome|ectopic ACTH production]]) | ||
* [[Hyperglycemia]] (high [[blood sugar]]s) | * [[Hyperglycemia]] (high [[blood sugar]]s) | ||
*[[Diabetes mellitus]] | *[[Diabetes mellitus]] | ||
*[[Osteoporosis]] | *[[Osteoporosis]] | ||
* Cardiovascular complications | * [[Cardiovascular]] complications: | ||
** | **[[Hypertension]] | ||
**[[Myocardial infarction]] | **[[Myocardial infarction]] | ||
**[[Left ventricular dysfunction]] | **[[Left ventricular dysfunction]] | ||
| Line 22: | Line 25: | ||
**Impaired [[fibrinolysis]]. | **Impaired [[fibrinolysis]]. | ||
*[[Major depression]] | *[[Major depression]] | ||
*[[ | *[[Anxiety disorders]] | ||
*[[Opportunistic infection|Opportunistic infections]] | *[[Opportunistic infection|Opportunistic infections]] | ||
*[[Sepsis]] | *[[Sepsis]] | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for those with Cushing's syndrome varies depending on the cause of the disease. Most cases of Cushing's syndrome can be cured. Many individuals with Cushing's syndrome show significant improvement with treatment, although some may find recovery complicated by various aspects of the causative illness. Some kinds of [[tumor]]s may recur. [[Mortality]] in | The prognosis for those with Cushing's syndrome varies depending on the cause of the disease. Most cases of Cushing's syndrome can be cured. Many individuals with Cushing's syndrome show significant improvement with treatment, although some may find recovery complicated by various aspects of the causative illness. Some kinds of [[tumor]]s may recur. [[Mortality]] in patients with Cushing's syndrome is increased even after the apparently successful treatment.<ref name="pmid25517021">{{cite journal |vauthors=Lodish M |title=Cushing's syndrome in childhood: update on genetics, treatment, and outcomes |journal=Curr Opin Endocrinol Diabetes Obes |volume=22 |issue=1 |pages=48–54 |year=2015 |pmid=25517021 |pmc=4415092 |doi=10.1097/MED.0000000000000127 |url=}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 13:27, 7 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Cushing's disease can lead to The symptoms of Cushing's syndrome usually start with symptoms such as rapid weight gain, a round face often referred to as a "moon face", and insomnia. It may progress to develop amenorrhoea, infertility and psychological disturbances. If left untreated, patients with Cushing's syndrome may progress to develop diabetes, cardiovascular and psychiatric complications. The prognosis depends on the severity of the disease.
Natural History
The symptoms of Cushing's syndrome usually start with symptoms such as rapid weight gain, a round face often referred to as a "moon face", and insomnia. It may progress to develop amenorrhoea, infertility, and psychological disturbances. If left untreated, patients with Cushing's syndrome may progress to develop diabetes mellitus and cardiovascular complications.
Complications
Cushing's syndrome can lead to the following complications:[1][2]
- Insulin resistance (especially common in ectopic ACTH production)
- Hyperglycemia (high blood sugars)
- Diabetes mellitus
- Osteoporosis
- Cardiovascular complications:
- Hypercoagulable state as a result of:
- Activated coagulation cascade
- Impaired fibrinolysis.
- Major depression
- Anxiety disorders
- Opportunistic infections
- Sepsis
Prognosis
The prognosis for those with Cushing's syndrome varies depending on the cause of the disease. Most cases of Cushing's syndrome can be cured. Many individuals with Cushing's syndrome show significant improvement with treatment, although some may find recovery complicated by various aspects of the causative illness. Some kinds of tumors may recur. Mortality in patients with Cushing's syndrome is increased even after the apparently successful treatment.[3]
References
- ↑ Lacroix A, Feelders RA, Stratakis CA, Nieman LK (2015). "Cushing's syndrome". Lancet. 386 (9996): 913–27. doi:10.1016/S0140-6736(14)61375-1. PMID 26004339.
- ↑ "Increased risk of osteoporotic fractures in patients with Cushing's syndrome".
- ↑ Lodish M (2015). "Cushing's syndrome in childhood: update on genetics, treatment, and outcomes". Curr Opin Endocrinol Diabetes Obes. 22 (1): 48–54. doi:10.1097/MED.0000000000000127. PMC 4415092. PMID 25517021.