{"id":25,"date":"2013-10-14T02:28:18","date_gmt":"2013-10-14T02:28:18","guid":{"rendered":"http:\/\/www.modestosurgery.com\/surgeryblog\/?p=25"},"modified":"2013-10-14T05:04:09","modified_gmt":"2013-10-14T05:04:09","slug":"subclinical-cushing-syndrome","status":"publish","type":"post","link":"http:\/\/www.modestosurgery.com\/surgeryblog\/subclinical-cushing-syndrome\/","title":{"rendered":"Subclinical Cushing Syndrome"},"content":{"rendered":"<h2>What is subclinical cushing&#8217;s syndrome?<\/h2>\n<ul>\n<li>subclinical hypercortisolism \/ may be observed with adrenal incidentaloma<\/li>\n<li>autonomous clucocorticoid production without specific signs and symptoms of Cushing&#8217;s syndrome.<\/li>\n<li>Much more common than classic Cushing&#8217;s syndrome<\/li>\n<li>Patients have a high prevalence of obesity, hypertension, and type 2 diabetes.<\/li>\n<li>Patients with incidentally detected adrenal masses who are about to undergo surgery should have testing for subclinical Cushing&#8217;s to avoid postoperative adrenal crisis..<\/li>\n<li>Best test is short dexamethasone suppression test.<\/li>\n<\/ul>\n<p><span style=\"font-family: Bitter, Georgia, serif; font-size: 22px; line-height: 1.3;\">What is Cushing&#8217;s syndrome?<\/span><\/p>\n<ul>\n<li>exaggerated facial roundness,<\/li>\n<li>weight gain around the midsection and upper back<\/li>\n<li>thinning of arms and legs.<\/li>\n<li>stretch marks<\/li>\n<li>hypertension<\/li>\n<li>diabetes<\/li>\n<li>Cushing&#8217;s syndrome occurs when exposed to high levels of the hormone cortisol for an extended period of time.<\/li>\n<li>this can either occur with taking too much corticosteroid medication or when the body makes too much cortisol.<\/li>\n<\/ul>\n<ol>\n<li>Pituitary adenoma &#8211; secreting excess <strong>ACTH which stimulates the adrenal glands to make more cortisol<\/strong><\/li>\n<li>Ectopic ACTH secreting tumor (ie. Lungs, pancreas, thyroid or thymus gland)<\/li>\n<li>Primary Adrenal Gland disease<\/li>\n<li>Familial Cushing syndrome<\/li>\n<\/ol>\n<h3>Diabetes type 1 vs. type 2<\/h3>\n<p>Type 1 = immune disorder. \u00a0Body attacks and destroys insulin producing beta cells in the pancreas. \u00a0Must take insulin. \u00a0Sometimes called insulin dependent or juvenile onset diabetes.<\/p>\n<p>Type 2 = either the body doesn&#8217;t produce enough insulin or the cells ignore the insulin (resistant). \u00a0Sometimes called adult onset diabetes. \u00a0Obesity is the strongest risk factor for type 2 diabetes.<\/p>\n<h3>Adrenalectomy for subclinical Cushing&#8217;s Syndrome?<\/h3>\n<p><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2265.2011.04253.x\/pdf\">http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2265.2011.04253.x\/pdf<\/a><\/p>\n<p>Adrenalectomy may lead to cure or better control of diseases associated with subclinical Cushing&#8217;s syndrome such as diabetes and hypertension<\/p>\n<h3>\u00a0Adrenal Incidentalomas<\/h3>\n<p>Most pose no clinical problems.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What is subclinical cushing&#8217;s syndrome? subclinical hypercortisolism \/ may be observed with adrenal incidentaloma autonomous clucocorticoid production without specific signs and symptoms of Cushing&#8217;s syndrome. Much more common than classic Cushing&#8217;s syndrome Patients have a high prevalence of obesity, hypertension, and type 2 diabetes. Patients with incidentally detected adrenal masses who are about to undergo &hellip; <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/subclinical-cushing-syndrome\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Subclinical Cushing Syndrome<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30,29,23,31,28,1],"tags":[32],"class_list":["post-25","post","type-post","status-publish","format-standard","hentry","category-adrenalectomy","category-diabtetes","category-endocrine","category-hypertension","category-subclinical-cushings-syndrome","category-uncategorized","tag-acth"],"_links":{"self":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/25","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/comments?post=25"}],"version-history":[{"count":6,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/25\/revisions"}],"predecessor-version":[{"id":36,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/25\/revisions\/36"}],"wp:attachment":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/media?parent=25"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/categories?post=25"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/tags?post=25"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}