Cushing's Syndrome: Clinical Differential Diagnosis and Complications

Article1 July 1959CUSHING'S SYNDROME: CLINICAL DIFFERENTIAL DIAGNOSIS AND COMPLICATIONSLEWIS M. HURXTHAL, M.D., F.A.C.P., JOHN B. O'SULLIVAN, M.D.LEWIS M. HURXTHAL, M.D., F.A.C.P., JOHN B. O'SULLIVAN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-51-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is now accepted that the immediate cause of Cushing's syndrome is adrenocortical hyperfunction, regardless of the possible etiologic part played by the pituitary gland or the hypothalamus. The average duration of this syndrome from onset to death was estimated by Cushing1to be slightly over five years. The major causes of death are infection, complications of cardiovascular disease, and neoplastic disease.2The duration of the disease and its severity are considered to be important factors in treatment and prognosis.3With a condition which is so potentially fatal, and in which the ravages of the disease are in part proportional...Bibliography1. Cushing H: Basophil adenomas of pituitary body and their clinical manifestations (pituitary basophilism), Bull. Johns Hopkins Hosp. 50: 137-195, 1932. Google Scholar2. PlotzKnowltonRagan CMAIC: Natural history of Cushing's syndrome, Am. J. Med. 13: 597-614 (Nov.) 1952. CrossrefMedlineGoogle Scholar3. Sosman MC: Cushing's disease—pituitary basophilism, Caldwell lecture, 1947, Am. J. Roentgenol. 62: 1-32 (July) 1949. Google Scholar4. LaidlawReddyJenkinsHaydarRenoldThorn JCWJDNAAEGW: Advances in the diagnosis of altered states of adrenocortical function, New England J. Med. 253: 747-753 (Nov. 3) 1955. CrossrefMedlineGoogle Scholar5. Williams RH, Editor: Textbook of endocrinology, 1955, W. B. Saunders Company, Philadelphia, pp. 276-281. Google Scholar6. O'SullivanSmedalHurxthal JBMILM: Unpublished data. Google Scholar7. CopeRaker OJW: Cushing's disease: surgical experience in the care of 46 cases, New England J. Med. 253: 119-127 (July 28) 1955. CrossrefMedlineGoogle Scholar8. Wolff FW: Cushing's syndrome presenting with features of "Type II" nephritis, Brit. M. J. 2: 1037-1038 (Nov. 4) 1950. CrossrefMedlineGoogle Scholar9. SofferEisenbergGannacconeGabrilove LJJAJL: Cushing's syndrome, Ciba Foundation Colloquia on Endocrinology, Vol. VIII: The human adrenal cortex, 1955, Little, Brown clinicopathologic report of 50 fatal cases and critique of literature, Medicine 28: 59-141 (Feb.) 1949. CrossrefMedlineGoogle Scholar23. JoslinRootWhiteMarble EPHFPA: The treatment of diabetes mellitus, 9th Ed., 1952, Lea & Febiger, Philadelphia. Google Scholar24. CrozierAinley REAB: Guillain-Barré syndrome, New England J. Med. 252: 83-88 (Jan. 20) 1955. CrossrefMedlineGoogle Scholar25. HirsonFeinmannWade CELHJ: Diabetic neuropathy, Brit. M. J. 1: 1408-1413 (June 27) 1953. CrossrefMedlineGoogle Scholar26. WaltersWilderKepler WRMEJ: The suprarenal cortical syndrome: report of two cases with successful surgical treatment, Proc. Staff Meet., Mayo Clin. 9: 400-407 (July 3) 1934. Google Scholar27. BirkeDiczfalusy GE: Fluctuation in the excretion of adrenocortical steroids in a case of Cushing's syndrome, J. Clin. Endocrinol. 16: 286-290 (Feb.) 1956. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts*Received for publication January 5, 1959.From the Department of Internal Medicine, The Lahey Clinic, Boston, Massachusetts.Requests for reprints should be addressed to Lewis M. Hurxthal, M.D., The Lahey Clinic, 605 Commonwealth Avenue, Boston 15, Massachusetts. 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