A Rational Approach to the Patient Suspected of Having Cushing’s Syndrome
In 1889 Sir William Osler detailed the case of a 31-year old man suffering from “an acute myxedematous condition, with tachycardia, glycosuria, melena, mania and death.” In particular, Osler was impressed by the rapid weight gain and the “bloated” appearance of his patient’s face. Unfortunately, however, the constellation of symptoms and signs that we now attribute to glucocorticoid excess had not been described and the patient succumbed while being treated for hypothyroidism. In 1932, Harvey Cushing described the clinical features associated with basophilic tumors of the pituitary. Since then, the association has become well characterized and patients with features due to glucocorticoid excess are said to have Cushing’s syndrome.
KeywordsMedullary Thyroid Carcinoma Dexamethasone Suppression Test Bronchial Carcinoid Glucocorticoid Excess Thymic Carcinoid
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