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[Cushing syndrome: When to suspect and how to confirm?].
[cushing syndrome]
Cushing
's
syndrome
includes
all
the
clinical
manifestations
induced
by
chronic
glucocorticoid
excess
.
The
endogenous
Cushing
's
syndrome
is
rare
,
but
its
prevalence
,
although
difficult
to
define
,
is
much
higher
in
populations
at
risk
.
Data
suggest
that
early
and
effective
management
would
reduce
morbidity
and
mortality
after
correction
of
hypercortisolism
.
It
is
not
recommended
to
widespread
test
for
Cushing
's
syndrome
but
targeted
screening
is
indicated
especially
in
the
following
indications
:
facio-troncular
obesity
,
hypercatabolism
signs
,
pituitary
and
adrenal
tumor
.
In
case
of
potential
but
less
specific
manifestation
of
Cushing
's
syndrome
(
diabetes
,
hypertension
,
osteoporosis
,
hypogonadism
…
)
,
but
unusual
for
age
,
familial
background
,
or
severity
,
particular
attention
will
be
paid
to
the
clinical
examination
to
search
for
signs
of
modest
hypercortisolism
which
may
justify
screening
.
The
positive
diagnosis
of
Cushing
's
syndrome
is
based
on
two
stages
approach
with
the
first
tests
simple
and
sensitive
,
and
the
second
tests
more
specific
,
with
investigations
to
determine
the
cause
following
a
positive
diagnosis
.
Diseases
Validation
Diseases presenting
"hypertension"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
cadasil
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
cystinuria
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kallmann syndrome
kindler syndrome
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
primary effusion lymphoma
scrub typhus
severe combined immunodeficiency
sneddon syndrome
typhoid
von hippel-lindau disease
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated