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A physiologic approach to diagnosis of the Cushing syndrome.

Raff, Hershel, Findling, James W.·2003·Annals of Internal Medicine

DOI 10.7326/0003-4819-138-12-200306170-00010

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Reviews17 June 2003A Physiologic Approach to Diagnosis of the Cushing SyndromeHershel Raff, PhD and James W. Findling, MDHershel Raff, PhDFrom St. Luke's Medical Center, Medical College of Wisconsin, Milwaukee, Wisconsin. and James W. Findling, MDFrom St. Luke's Medical Center, Medical College of Wisconsin, Milwaukee, Wisconsin.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical Principles*GeneralObesityHypertensionMetabolicDiabetes mellitus or impaired glucose toleranceHyperlipidemiaNephrolithiasisPolyuriaSkinPlethoraHirsutismStriaeAcneBruisingMusculoskeletalOsteopenia or osteoporosisProximal myopathyNeuropsychiatricDepressionCognitive impairmentEmotional labilityEuphoriaPsychosisGonadal dysfunctionOligomenorrhea or amenorrheaImpotence, decreased libidoImmune suppression (susceptible to opportunistic infection)*Notice that many of the features of the Cushing syndrome resemble those of the metabolic syndrome (e.g., obesity, hypertension, impaired glucose tolerance, hyperlipidemia, hirsutism, acne, and gonadal dysfunction).Pathophysiologic PrinciplesThe hypothalamicpituitaryadrenal axisControl of adrenal function and growthHypothalamic control of pituitary functionGlucocortcoid-negative feedbackCircadian rhythmThe stress responsePosttranslational processing of proopiomelanocortin to adrenocorticotropic hormoneCortisol plasma binding, metabolism, and excretionGlucocorticoid action11-hydroxysteroid dehydrogenase type 1 and 11-hydroxysteroid dehydrogenase type 2The relationship among obesity, impaired glucose tolerance or diabetes, hypertension, and gonadal dysfunction was initially ...References1. 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Authors: Raff, H., & Findling, J. W.
Affiliations: Medical College of Wisconsin (US)
ORCID: Raff, Hershel
Findling, James W.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2003-06-17
Volume: 138
Issue: 12
Pages: 980-991
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-138-12-200306170-00010
OpenAlex: W2043931645
Cited by: 186
References: 69
Citations by year: 2026: 3 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 6 · 2019: 8 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 13 · 2013: 5 · 2012: 10
FWCI: 2.56
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
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 › Nephrology › Electrolyte and hormonal disorders
Keywords: Cushing's syndrome, hypothalamic-pituitary-adrenal axis, cortisol, ACTH, 11β-hydroxysteroid dehydrogenase, metabolic syndrome, hypercortisolism, Cushing's disease, ectopic ACTH syndrome, ACTH stimulation test
MeSH terms: Cushing Syndrome, Diagnosis, Differential, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System

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A physiologic approach to diagnosis of the Cushing syndrome.

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