الفهرس | Only 14 pages are availabe for public view |
Abstract Although Cushing’s syndrome was described from the beginning of this century, diagnosis and management of this clinical entity remain one of the most difficult problems in clinical endocrinology. Beside the traditional etiology for Cushing’s syndrome (Pituitary corticoroph tumours, suprarenal tumors, ectopic ACTH and CRR secretion and iatrogenic Cushing’s syndrome), new rare causes have been reported e.g. (food dependent, catecholamine, vasopressin, progesterone dependent Cushing syndrome, cortisol hyper-reactive syndrome, familial resistance to glucocorticoids, and hyperfunction of adrenal rest tissue. Clinical picture of Cushing’s syndrome has a wide variation and atypical presentation are common. Although the full-blown Cushingoid features are unmistakable, many patients present with only few features of the syndrome. The full-blown clinical picture of Cushing’s syndrome include central obesity, fascial plethora, proximal muscle weakness, atrophic skin, stria, easy bruising, indolent infection, ulceration, cutaneous fungal infection, hirsutism. Cardiovascular symptoms in a form of hypertension, left ventricular hypertrophy, increased suscestability to occlusive arterial disease. Cushing’s syndrome is associated with suppression of immune function but infection with organisms of low pathogenicity occur only in severe hypercortisolism. |