Cushing syndrome

E24.0-4/E24.8-9

• Description
• General measures
• Referral

DESCRIPTION

Cushing syndrome is an illness resulting from excess cortisol secretion or exogenous glucocorticoid administration. Cushing disease is hypercortisolism secondary to an ACTH-secreting pituitary tumour.

Investigations

Low dose overnight dexamethasone suppression test (or when unavailable, betamethasone 1 mg equivalent to dexamethasone 1 mg).

• Dexamethasone, oral, 1 mg.
  • Administer at 23:00.
  • Measure plasma cortisol at 8:00, the next morning after breakfast.
  • In people with normal pituitary and adrenal function morning cortisol will be suppressed to <50 nmol/L.
  • Refer if cortisol levels >50 nmol/L.

LoEIII [8]

GENERAL MEASURES

Check for hypertension and diabetes and treat accordingly.

Check potassium.

REFERRAL

All cases for investigation of aetiology and appropriate management.