Glucocorticoid Action and the Clinical Features of Cushing’s Syndrome

Yanovski, Jack A.; Cutler, Gordon B.

doi:10.1016/s0889-8529(18)30080-x

Cited by 108 publications

(65 citation statements)

References 119 publications

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“…Compared to similar studies, striae, acne, acanthosis nigricans and hirsutism were less frequent; hyperpigmentation, ecchymosis and fungal infections were more frequent in our study [17]. Differences in skin finding frequencies can be attributed to similar studies being conducted on patients with free endogenous CS and the duration of exposure to cortisone in exogenous Cushing's patients on our follow-up [14]. Table 3.…”

Section: Discussioncontrasting

confidence: 54%

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Differences in skin lesions of endogenous and exogenous Cushing’s patients

Erden

Borlu²,

Şimşek³

et al. 2019

pdia

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A b s t r a c tIntroduction: Cushing's syndrome is a rare condition characterized by increased glucocorticoid levels. Dermatologically, it causes a variety of skin conditions such as atrophy, striae, acne, plethora, hypertrichosis, hirsutism, acanthosis nigricans, hyperpigmentation, alopecia, purpura and fragile skin. Although skin lesions of Cushing's syndrome have been described, exogenous and endogenous types have not been studied in detail. Aim: To determine differences in possible skin lesions depending on the cause of Cushing's syndrome. Material and methods: A total of 35 patients -16 iatrogenic Cushing's syndrome patients and 19 endogenous Cushing's syndrome patients -who were diagnosed in Erciyes University and 15 healthy individuals were included in this study. Results: There was at least one skin finding in 34 (97.1%) of the patients with Cushing's syndrome and 9 (60%) in the control group (p = 0.001). Comparison regarding skin findings in patient and control groups revealed that hypertrichosis, hyperpigmentation, and fungal infections were significantly more frequent in the patient group than the control group. Hirsutism was found more frequently in the endogenous group whereas stria, hypertrichosis and fungal infections were more frequent in the exogenous group. Conclusions: Since Cushing's syndrome is a rare disease and it is often diagnosed later in life, data on the frequency of skin findings are limited and sparse in the literature. In the comparison of endogenous Cushing's and exogenous Cushing's groups, acne, hypertrichosis, and fungal infections were found more frequently in the exogenous Cushing's group and hirsutism more frequently in the endogenous Cushing's group.

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Section: Discussioncontrasting

confidence: 54%

“…The developing striae based on CS are pinker and wider, while the striae base on weight gain are paler and narrower. Taking this into account, the striae were evaluated according to their color: 0: none, 1: mild, 2: moderate and 3: severe [14]. Flexural areas such as axilla, inguinal, and neck were evaluated for acanthosis nigricans.…”

Section: Methodsmentioning

confidence: 99%

Differences in skin lesions of endogenous and exogenous Cushing’s patients

Erden

Borlu²,

Şimşek³

et al. 2019

pdia

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“…Stress, metastasis of malignancy, excessive secretion of gastrointestinal fluid, diverticulitis, and gastrointestinal tumours may lead to intestinal perforation in patients with diverticulosis [8]. On the other hand, corticosteroid excess may prone to collagen damage and easy injury [9,10]. The lamina propria of large intestine mucosa is consists of a thick layer of collagen and ground substance.…”

Section: Discussionmentioning

confidence: 99%

“…The lamina propria of large intestine mucosa is consists of a thick layer of collagen and ground substance. Since collagen protein is a major component of lamina propria of large intestine, decreased proportion of this protein should cause a reduction in intestine fold thickness [9,10]. In this context, increased endogenous glucocorticoid because of EAS may have contributed to the bowel perforation by causing tissue fragility.…”

Section: Discussionmentioning

confidence: 99%

Severe Hypokalaemia, Hypertension, and Intestinal Perforation in Ectopic Adrenocorticotropic Hormone Syndrome

Kaya

Karacaer

Açıkgöz

et al. 2016

JCDR

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A 70-year-old man was admitted to the emergency department of our hospital with weakness, inappetence, and jaundice. He had these complaints for approximately 15 days and he was unable to walk because of his symptoms and condition. He had been using ramipril and hydrochlorothiazide, owing to hypertension for approximately 10 years. He was a 15-pack-year smoker for 40 years. On examination, he was oriented, co-operative, and afebrile. Blood pressure was 180/95 mmHg, pulse rate 80 beats/min, and respiratory rate 20 breaths/min. He was icteric and muscle strength was graded as 3/5 in all the extremities. Laboratory results were as follows: urea 101 mg/dL; creatinine 1.1 mg/dl; uric acid 13.4 mg/dL; calcium 8.7 mg/dL; phosphorus 2.7 mg/dL; AST 160 U/L; ALT 133 U/L; lactic dehydrogenase 1284 U/L; amylase 84 U/L; total bilirubin 5.8 mg/dL; direct bilirubin 5.2 mg/dL; albumin 3 g/dL; sodium 145; chloride 74 mmol/L; potassium 1.6 mmol/L; prothrombine time 10.4 s; INR 0.97; haemoglobin 14.3 gr/dl; white cell count 12900 K/uL; and thrombocyte 265000 K/uL. Viral hepatitis markers were negative. The blood gas analysis was indicative of metabolic alkalosis with a pH of 7.52, PaCO 2 of 37.1, and HCO 3 of 38.1. Electrocardiogram revealed a normal sinus rhythm with prominent U waves [Table/ Fig-1 ABSTRACTEctopic adrenocorticotropic hormone (ACTH) syndrome is a rare cause of the Cushing's syndrome. The occurrence of the ectopic ACTH syndrome presenting with severe hypokalaemia, metabolic alkalosis, and hypertension has been highlighted in case reports. However, presentation with lower gastrointestinal perforation is not known. We report the case of a 70-year-old male patient with severe hypokalaemia, metabolic alkalosis, hypertension, and colonic perforation as manifestations of an ACTH-secreting small cell lung carcinoma. Ectopic ACTH syndrome should be kept in mind as a cause of hypokalaemia, hypertension, and intestinal perforation in patients with lung carcinoma.

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“…These increases are prominent, especially in depressive patients [46,47]. When considered from the perspective of cardiovascular system, high glucocorticoid levels play important role especially in hypertension, insulin resistance, hyperglycemia and weight gain [48,49]. Besides, if we remember that glucocorticoids basically play active role in inflammation, the connection between high glucocorticoid levels and atherosclerosis can be established easily.…”

Section: Hpa Axismentioning

confidence: 99%

Stress as a Risk Factor for Cardiovascular Events

C¹

2015

Cardiol Pharmacol

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Glucocorticoid Action and the Clinical Features of Cushing’s Syndrome

Cited by 108 publications

References 119 publications

Differences in skin lesions of endogenous and exogenous Cushing’s patients

Differences in skin lesions of endogenous and exogenous Cushing’s patients

Severe Hypokalaemia, Hypertension, and Intestinal Perforation in Ectopic Adrenocorticotropic Hormone Syndrome

Stress as a Risk Factor for Cardiovascular Events

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