Hershel Raff, PhD; James W. Findling, MD
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Hershel Raff, PhD, Endocrinology and Diabetes, St. Luke's Medical Center, 2801 W KK River Parkway, Suite 245, Milwaukee, WI 53215; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Raff and Findling: Endocrinology, St. Luke's Medical Center, Medical College of Wisconsin, 2801 W KK River Parkway, Suite 245, Milwaukee WI 53215.
Raff H., Findling J.; A Physiologic Approach to Diagnosis of the Cushing Syndrome. Ann Intern Med. 2003;138:980-991. doi: 10.7326/0003-4819-138-12-200306170-00010
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Published: Ann Intern Med. 2003;138(12):980-991.
Immune 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).
The relationship among obesity, impaired glucose tolerance or diabetes, hypertension, and gonadal dysfunction was initially recognized in two clinical syndromes described early in the 20th century. In 1932, Harvey Cushing reported these findings as well as other featu•res of endogenous hypercortisolism in patients with small basophilic pituitary adenomas (1). A decade earlier, two French physicians, Drs. Archard and Thiers, described a similar phenotype in the syndrome that is now recognized as the syndrome of insulin resistance (the metabolic syndrome) and the polycystic ovary syndrome (2).
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Endocrine and Metabolism, Adrenal Disorders.
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