Diagnosis of Cushing's Syndrome

Fig 1: Diagnosis Cushing's Syndrome
ACTH: AdrenoCorticoTropic Hormone; IPSS: Inferior Petrosal Sinus Sampling; CRH: Corticotrophin Releasing Hormone

↓DOSE:    1-2mg  →  ↓Cortisol  →  ΘEndogenous pathology

↑DOSE:    8mg     →    -Feedback on pituitary

                             → ΘFeedback on  →   Ectopic ACTH

                                                          →  Adrenal Adenoma                 

↓DOSE  →   ↓Cortisol  →   Normal -feedback

              →   =Cortisol  →  ↑DOSE  →   ↓Cortisol  →  1ºAdrenal

                                                     →   =Cortisol  →  Ectopic ACTH  →  CXR/ CT Abdo

                                                     →   ↑Cortisol  →  Cushing's dis     →  MRI Pituitary, ΘCushingoid    

Relevant articles

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Further Reading | Fig 1