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Cited by 68Pituitary Gland Disorders and TreatmentsAdrenal Hormones and DisordersElectrolyte and hormonal disorders

Approach to patients with pseudo-Cushing’s states

Open access
Scaroni, Carla, Albiger, Nora M, Palmieri, Serena, Iacuaniello, Davide, Graziadio, Chiara, Damiani, Luca, Zilio, Marialuisa, Stigliano, Antonio +3 more·2020·Endocrine Connections
DOI 10.1530/ec-19-0435PMC PMC6993268
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Abstract

The distinction between pseudo-Cushing’s states (PCS) and Cushing’s syndrome (CS) poses a significant clinical challenge even for expert endocrinologists. A patient’s clinical history can sometimes help to distinguish between them (as in the case of alcoholic individuals), but the overlap in clinical and laboratory findings makes it difficult to arrive at a definitive diagnosis. We aim to describe the most common situations that can give rise to a condition resembling overt endogenous hypercortisolism and try to answer questions that physicians often face in clinical practice. It is important to know the relative prevalence of these different situations, bearing in mind that most of the conditions generating PCS are relatively common (such as metabolic syndrome and polycystic ovary syndrome), while CS is rare in the general population. Physicians should consider CS in the presence of additional features. Appropriate treatment of underlying conditions is essential as it can reverse the hormonal abnormalities associated with PCS. Close surveillance and a thorough assessment of a patient’s hormone status will ultimately orient the diagnosis and treatment options over time.

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  • Pseudo-Cushing states, such as severe obesity, alcoholism, polycystic ovary syndrome, and neuropsychiatric disorders, are beyond compare more prevalent than endogenous Cushing syndrome.

    “These pseudo-Cushing states, such as with severe obesity, alcoholism, polycystic ovary syndrome, and neuropsychiatric disorders, are beyond compare more prevalent than endogenous CS (40) (see also subparagraph “Pseudo-Cushing’s syndrome”).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [40]

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  1. [11]Vastbinder M Kuindersma M Mulder AH Schuijt MP Mudde AH The influence of oral contraceptives on overnight 1 mg dexamethasone suppression test. Netherlands Journal of Medicine 2016 158– 161. 27185774
  2. [17]Deuschle M Schweiger U Weber B Gotthardt U Korner A Schmider J Standhardt H Lammers CH Heuser I Diurnal activity and pulsatility of the hypothalamus-pituitary-adrenal system in male depressed patients and healthy controls. Journal of Clinical Endocrinology and Metabolism 1997 234– 238. (10.1210/jcem.82.1.3689) 8989265 · DOI · Paper page
  3. [21]Carroll BJ Use of the dexamethasone suppression test in depression. Journal of Clinical Psychiatry 1982 44– 50. 7174632
  4. [43]Rosmond R Dallman MF Björntorp P Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine metabolic and hemodynamic abnormalities. Journal of Clinical Endocrinology and Metabolism 1998 1853– 1859. (10.1210/jcem.83.6.4843) 9626108 · DOI
  5. [53]Besemer F Pereira AM Smit JWA Alcohol-induced Cushing syndrome. Hypercortisolism caused by alcohol abuse. Netherlands Journal of Medicine 2011 318– 323. 21934176

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Authors
Scaroni, C., Albiger, N. M., Palmieri, S., Iacuaniello, D., Graziadio, C., Damiani, L., Zilio, M., Stigliano, A., Colao, A., Pivonello, R., & _, _.
Affiliations
  • University of Padua (IT)
  • University of Milan (IT)
  • University of Naples Federico II (IT)
  • Sapienza University of Rome (IT)
  • University of Ferrara (IT)
  • Azienda Ospedaliera Sant'Andrea (IT)
Corresponding author
Scaroni, Carla
ORCID
Venue
Endocrine Connections
Publisher
Bioscientifica
Published
2020-01
Volume
9
Issue
1
Pages
R1-R13
ISSN
2049-3614 (ISSN-L)
DOI
10.1530/ec-19-0435
PMC
PMC6993268
OpenAlex
W2996241952
Cited by
68
References
73
Citations by year
2026: 10 · 2025: 10 · 2024: 6 · 2023: 13 · 2022: 13 · 2021: 13 · 2020: 2 · 2018: 1
FWCI
1.57
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Endocrine Connections (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
Keywords
pseudo-Cushing's syndrome, Cushing's syndrome, endogenous hypercortisolism, differential diagnosis, metabolic syndrome, polycystic ovary syndrome, alcoholism

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