Collection of signs and symptoms resulting from excess cortisol

Demographics

• Adults 20-50
• Females

Aetiology

ACTH dependant (85%)

• overstimulation of both adrenal glands by excess adrenocorticotrophic hormone (ACTH) production from:
  • a pituitary adenoma (Cushing disease) common adult cause
  • an ectopic ACTH-producing tumour (SCLC, pheochromocytoma)

ACTH independent (15%)

• exogenous administration of glucocorticoids (most common cause in children)
• endogenous production of cortisol by an adrenal adenoma or carcinoma
• bilateral nodular adrenal hyperplasia (rare)

Pathophysiology

• Cortisol produced in zona fasciculata of adrenal cortex
• released under stressful conditions
• binds intracellularly to all cells