Elena Valassi
Elena Valassi
Endocrinology Department, Germans Trias i Pujol Hospital and Research Institute, Badalona, Barcelona, Spain
IRCCS, Istituto Auxologico Italiano, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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IRCCS, Istituto Auxologico Italiano, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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Iacopo Chiodini
Iacopo Chiodini
IRCCS, Istituto Auxologico Italiano, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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Richard A Feelders
Richard A Feelders
Division of Endocrinology, Erasmus Medical Centre, Rotterdam, Netherlands
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Cornelie D Andela
Cornelie D Andela
Division of Endocrinology and Centre for Endocrine Tumours, Leiden University Medical Centre, Leiden, Netherlands
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Margueritta Abou-Hanna
Margueritta Abou-Hanna
HRA Pharma Rare Diseases, Châtillon, France
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Sarah Idres
Sarah Idres
HRA Pharma Rare Diseases, Châtillon, France
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Antoine Tabarin
Antoine Tabarin
Department of Endocrinology and INSERM U862 University and CHU of Bordeaux, Pessac, France
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Introduction Cushing’s syndrome (CS) is a morbid endocrine condition due to prolonged exposure to high circulating cortisol levels ( 1 , 2 , 3 ). Hypercortisolism may cause irreversible physical and psychological changes in several tissues
M S Elston
M S Elston
Department of Endocrinology, Waikato Hospital, Hamilton, New Zealand
Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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V B Crawford
V B Crawford
Department of Endocrinology, Waikato Hospital, Hamilton, New Zealand
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M Swarbrick
M Swarbrick
Department of Radiology, Waikato Hospital, Hamilton, New Zealand
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M S Dray
M S Dray
Department of Pathology, Waikato Hospital, Hamilton, New Zealand
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M Head
M Head
Department of Oncology, Tauranga Hospital, Tauranga, New Zealand
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J V Conaglen
J V Conaglen
Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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* Died shortly after first dose. AdenoCa, prostate adenocarcinoma; CS, Cushing’s syndrome; dx, diagnosis; hx, history; MR, mineralocorticoid. Of the reported cases of CS associated with SCPC most are due to ectopic ACTH production ( 24
Ramjan Sanas Mohamed
Ramjan Sanas Mohamed
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Biyaser Abuelgasim
Biyaser Abuelgasim
Imperial College School of Medicine, Department of Biochemistry, Imperial College Healthcare NHS Trust, London, UK
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Sally Barker
Sally Barker
Imperial College School of Medicine, Department of Biochemistry, Imperial College Healthcare NHS Trust, London, UK
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Hemanth Prabhudev
Hemanth Prabhudev
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Niamh M Martin
Niamh M Martin
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Karim Meeran
Karim Meeran
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Emma L Williams
Emma L Williams
Department of Biochemistry, Imperial College Healthcare NHS Trust, London, UK
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Sarah Darch
Sarah Darch
Department of Biochemistry, Imperial College Healthcare NHS Trust, London, UK
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Whitlock Matthew
Whitlock Matthew
Department of Biochemistry, Imperial College Healthcare NHS Trust, London, UK
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Tricia Tan
Tricia Tan
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Florian Wernig
Florian Wernig
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Introduction Cushing’s syndrome (CS) is caused by prolonged and inappropriate exposure of tissues to glucocorticoids ( 1 ). Endogenous CS often poses considerable diagnostic challenges. Most guidelines recommend two different tests to screen
Agata Hanna Bryk-Wiązania
Agata Hanna Bryk-Wiązania
Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Mari Minasyan
Mari Minasyan
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Alicja Hubalewska-Dydejczyk
Alicja Hubalewska-Dydejczyk
Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Aleksandra Gilis-Januszewska
Aleksandra Gilis-Januszewska
Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Introduction Cushing’s syndrome (CS) is a rare disease with an incidence ranging from 0.7 to 2.4 per million people per year ( 1 ). In contrast, venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep-vein thrombosis (DVT
Boni Xiang
Boni Xiang
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Ran Tao
Ran Tao
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Xinhua Liu
Xinhua Liu
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Xiaoming Zhu
Xiaoming Zhu
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Min He
Min He
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Zengyi Ma
Zengyi Ma
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
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Yehong Yang
Yehong Yang
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Zhaoyun Zhang
Zhaoyun Zhang
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Yiming Li
Yiming Li
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Zhenwei Yao
Zhenwei Yao
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
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Yongfei Wang
Yongfei Wang
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
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Hongying Ye
Hongying Ye
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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Introduction Cushing’s syndrome (CS) comprises diverse manifestations resulting from chronic exposure to excess glucocorticoids. The incidence is 0.2–5.0 per million people per year. Approximately 80% of endogenous CS is adrenocorticotrophin
Soraya Puglisi
Soraya Puglisi
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Paola Perotti
Paola Perotti
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Mattia Barbot
Mattia Barbot
Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
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Paolo Cosio
Paolo Cosio
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Carla Scaroni
Carla Scaroni
Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
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Antonio Stigliano
Antonio Stigliano
Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital University of Rome, Rome, Italy
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Pina Lardo
Pina Lardo
Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital University of Rome, Rome, Italy
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Valentina Morelli
Valentina Morelli
Endocrinology Unit, Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
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Elisa Polledri
Elisa Polledri
Department of Clinical Sciences and Community Health, Laboratory of Toxicology, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Iacopo Chiodini
Iacopo Chiodini
Endocrinology Unit, Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
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Giuseppe Reimondo
Giuseppe Reimondo
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Anna Pia
Anna Pia
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Massimo Terzolo
Massimo Terzolo
Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Introduction Cushing’s syndrome (CS) is a condition of endogenous hypercortisolism caused by different pathological entities that is classified in two variants: (i) ACTH-dependent CS, due to a corticotroph pituitary adenoma or an ectopic tumor
Jingya Zhou
Jingya Zhou
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Meng Zhang
Meng Zhang
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Lin Lu
Lin Lu
Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Key Laboratory of Endocrinology of National Health Commission of People’s Republic of China, Beijing, China
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Key Laboratory of Endocrinology of National Health Commission of People’s Republic of China, Beijing, China
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Xiaopeng Guo
Xiaopeng Guo
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Lu Gao
Lu Gao
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Weigang Yan
Weigang Yan
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Haiyu Pang
Haiyu Pang
Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yi Wang
Yi Wang
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Bing Xing
Bing Xing
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Introduction Endogenous Cushing’s syndrome (CS) comprises signs and symptoms caused by pathological hypercortisolism, which seriously affects the metabolic and endocrine systems. Endogenous CS is divided between adrenocorticotropic hormone
Carla Scaroni
Carla Scaroni
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Nora M Albiger
Nora M Albiger
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Serena Palmieri
Serena Palmieri
Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Davide Iacuaniello
Davide Iacuaniello
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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Chiara Graziadio
Chiara Graziadio
Department of Experimental Medicine, University La Sapienza, Rome, Italy
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Luca Damiani
Luca Damiani
Department of Medical Sciences, Endocrinology and Internal Medicine Section, University of Ferrara, Ferrara, Italy
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Marialuisa Zilio
Marialuisa Zilio
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Antonio Stigliano
Antonio Stigliano
Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University La Sapienza, Rome, Italy
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Annamaria Colao
Annamaria Colao
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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Rosario Pivonello
Rosario Pivonello
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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the Altogether to Beat Cushing’s Syndrome (ABC) study group
the Altogether to Beat Cushing’s Syndrome (ABC) study group
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( 2 ). Under such conditions, there may be some clinical signs of hypercortisolism, which may be temporary or more persistent, giving rise to what is called pseudo-Cushing’s syndrome (PCS). The differential diagnosis of PCS and Cushing’s syndrome (CS
Hanna F Nowotny
Hanna F Nowotny
Medizinische Klinik IV, Department of Endocrinology, Klinikum der Universität München, Munich, Germany
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Jillian Bryce
Jillian Bryce
Office for Rare Conditions, University of Glasgow, Glasgow, UK
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Salma R Ali
Salma R Ali
Office for Rare Conditions, University of Glasgow, Glasgow, UK
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Roberta Giordano
Roberta Giordano
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
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Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
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Federico Baronio
Federico Baronio
Pediatric Unit, Department Hospital of Woman and Child, Endo-ERN Centre IT11, IRCSS AOU S.Orsola-Malpighi University Hospital, Bologna, Italy
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Irina Chifu
Irina Chifu
Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital of Wuerzburg, University of Wuerzburg, Wuerzburg, Germany
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Lea Tschaidse
Lea Tschaidse
Medizinische Klinik IV, Department of Endocrinology, Klinikum der Universität München, Munich, Germany
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Martine Cools
Martine Cools
Department of Paediatric Endocrinology, Ghent University Hospital, University of Ghent, Ghent, Belgium
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Erica LT van den Akker
Erica LT van den Akker
Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus MC - Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
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Henrik Falhammar
Henrik Falhammar
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
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Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
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Natasha M Appelman-Dijkstra
Natasha M Appelman-Dijkstra
Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
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Luca Persani
Luca Persani
Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan Italy
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Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan Italy
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Guglielmo Beccuti
Guglielmo Beccuti
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Ian L Ross
Ian L Ross
Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Simona Grozinsky-Glasberg
Simona Grozinsky-Glasberg
Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of Endocrinology and Metabolism, Hadassah Medical Organisation and Faculty of Medicine, the Hebrew University, Jerusalem, Israel
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Alberto M Pereira
Alberto M Pereira
Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
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Eystein S Husebye
Eystein S Husebye
Department of Clinical Science and KG Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Department of Medicine, Haukeland University Hospital, Bergen, Norway
Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Stefanie Hahner
Stefanie Hahner
Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital of Wuerzburg, University of Wuerzburg, Wuerzburg, Germany
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S Faisal Ahmed
S Faisal Ahmed
Office for Rare Conditions, University of Glasgow, Glasgow, UK
Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
Developmental Endocrinology Research Group, University of Glasgow, Glasgow, United Kingdom
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Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
Developmental Endocrinology Research Group, University of Glasgow, Glasgow, United Kingdom
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Nicole Reisch
Nicole Reisch
Medizinische Klinik IV, Department of Endocrinology, Klinikum der Universität München, Munich, Germany
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AI and long-term glucocorticoid substitution therapy or glucocorticoid excess in Cushing’s syndrome (CS), are regularly prone to infections, especially those of the upper airways and gastrointestinal tract, due to impaired immune cell function ( 17
Benedetta Zampetti
Benedetta Zampetti
Department of Endocrinology, Ospedale Niguarda, Milano, Italy
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Erika Grossrubatscher
Erika Grossrubatscher
Department of Endocrinology, Ospedale Niguarda, Milano, Italy
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Paolo Dalino Ciaramella
Paolo Dalino Ciaramella
Department of Endocrinology, Ospedale Niguarda, Milano, Italy
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Edoardo Boccardi
Edoardo Boccardi
Department of Neuroradiology, Ospedale Niguarda, Milano, Italy
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Paola Loli
Paola Loli
Department of Endocrinology, Ospedale Niguarda, Milano, Italy
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ACTH-dependent hypercortisolism is highly suggestive of pituitary disease, this is not true for smaller lesions that still might be incidentaloma ( 16 , 17 ). The Consensus Statement on Diagnosis and Complications of Cushing’s Syndrome suggests 6mm as
