Physiopathology, Diagnosis, and Treatment of Hypercortisolism

  • Rosario Pivonello
  • Davide Iacuaniello
  • Chiara Simeoli
  • Maria Cristina De Martino
  • Annamaria Colao
Reference work entry
Part of the Endocrinology book series (ENDOCR)


Cushing’s syndrome (CS) is a serious clinical condition caused by endogenous or exogenous cortisol excess. Endogenous CS is a rare endocrine disorder caused by chronic excessive cortisol secretion. In approximately 80% of cases, endogenous CS is a consequence of an adrenocorticotropin (ACTH) hypersecretion (ACTH-dependent CS), generally due to a ACTH-secreting pituitary tumor (Cushing’s disease, CD, 70%), and, rarely, to an ACTH-secreting or corticotrophin releasing hormone (CRH)-secreting extra-pituitary tumor (Ectopic CS, ECS, 10%). In the remaining 20% of cases, CS is a direct consequence of autonomous cortisol overproduction by the adrenal glands (ACTH-independent CS), because of unilateral or bilateral adrenal diseases. This chapter reviews the physiopathology, the diagnostic algorithm required to establish the diagnosis and the main currently available treatments of CS.


Cushing’s syndrome Cushing’s disease Ectopic Cushing’s syndrome Adrenal Cushing’s syndrome Cortisol Adrenocorticotropin Glucocorticoids 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Rosario Pivonello
    • 1
  • Davide Iacuaniello
    • 1
  • Chiara Simeoli
    • 1
  • Maria Cristina De Martino
    • 1
  • Annamaria Colao
    • 1
  1. 1.Dipartimento di Medicina Clinica e Chirurgia, Sezione di EndocrinologiaUniversità Federico II di NapoliNaplesItaly

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