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Cited by 210Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

Cushing's syndrome: epidemiology and developments in disease management

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Feelders, Richard, Sharma, Susmeeta, Nieman, Lynnette·2015·Clinical Epidemiology
DOI 10.2147/clep.s44336PMC PMC4407747
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Abstract

Cushing's syndrome is a rare disorder resulting from prolonged exposure to excess glucocorticoids. Early diagnosis and treatment of Cushing's syndrome is associated with a decrease in morbidity and mortality. Clinical presentation can be highly variable, and establishing the diagnosis can often be difficult. Surgery (resection of the pituitary or ectopic source of adrenocorticotropic hormone, or unilateral or bilateral adrenalectomy) remains the optimal treatment in all forms of Cushing's syndrome, but may not always lead to remission. Medical therapy (steroidogenesis inhibitors, agents that decrease adrenocorticotropic hormone levels or glucocorticoid receptor antagonists) and pituitary radiotherapy may be needed as an adjunct. A multidisciplinary approach, long-term follow-up, and treatment modalities customized to each individual are essential for optimal control of hypercortisolemia and management of comorbidities.

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  • ACTH-independent Cushing syndrome accounts for 15% to 20% of cases.

    “ACTH-dependent CS accounts for 80% to 85% of cases and ACTH-independent accounts for 15% to 20% (2, 4, 5).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [5]

    The Classification of Cushing’s syndrome section states that ACTH-independent disease accounts for 15%–20% of endogenous Cushing’s syndrome in adults. The citing sentence gives the same percentage but does not specify those limits, so the source does not establish it for all Cushing syndrome cases. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Patients with Cushing syndrome often present with nonspecific features such as abdominal obesity and weight gain, rounded (moon) face, menstrual irregularity, and depression.

    “Patients often present with nonspecific features such as (abdominal) obesity and weight gain, rounded (moon) face, menstrual irregularity, and depression (1, 3, 5) as depicted in Figure 1.”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [5]

    The Clinical features section identifies weight gain as the most common sign, says increased visceral adipose tissue is common, and describes menstrual irregularity and depression in patients with Cushing’s syndrome. It also says no single symptom is pathognomonic, consistent with the claim that these features are nonspecific. The passages from our copy do not mention a rounded or “moon” face. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • ACTH-dependent Cushing syndrome accounts for 80% to 85% of cases.

    “ACTH-dependent CS accounts for 80% to 85% of cases and ACTH-independent accounts for 15% to 20% (2, 4, 5).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [5]

  • The clinical presentation of Cushing syndrome can be variable, depending on a patient's age, sex, severity, and duration of cortisol excess.

    “The clinical presentation of CS can be variable, depending on a patient’s age, sex, severity, and duration of cortisol excess (Table 2) (1, 3, 5).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [5]

  • In EAS, the most common sources of ACTH secretion are small cell lung carcinomas or pulmonary carcinoid tumors.

    “In these cases, most common sources of ACTH secretion are small cell lung carcinomas or pulmonary carcinoid tumors.”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [5]

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Authors
Feelders, R., Sharma, S., & Nieman, L.
Affiliations
National Institutes of Health (US)
Corresponding author
Feelders, Richard
ORCID
Venue
Clinical Epidemiology
Publisher
Informa UK Limited
Published
2015-04
Volume
7
Pages
281
ISSN
1179-1349 (ISSN-L)
DOI
10.2147/clep.s44336
PMC
PMC4407747
OpenAlex
W2092816908
Cited by
210
References
28
Citations by year
2026: 8 · 2025: 16 · 2024: 26 · 2023: 21 · 2022: 31 · 2021: 27 · 2020: 19 · 2019: 17 · 2018: 17 · 2017: 13 · 2016: 13 · 2015: 2
FWCI
2.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Epidemiology (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
Cushing's syndrome, glucocorticoid excess, hypercortisolism, pituitary adenoma, ectopic ACTH syndrome, adrenalectomy, pituitary surgery, steroidogenesis inhibitors, glucocorticoid receptor antagonist, Cushing's disease, pituitary radiotherapy, comorbidity management, multidisciplinary care, epidemiology

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