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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
"chronic glucocorticoid"
symptom
congenital adrenal hyperplasia
cushing syndrome
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