Cushing's syndrome of nonpituitary causes.
OBJECTIVE
Cushing's syndrome is being recognized with greater frequency and in patients with milder disease. Many of these individuals have nonpituitary causes of their hypercortisolism. This review discusses the classification, presentation, diagnosis, and therapy of patients with Cushing's syndrome from nonpituitary causes.


RESULTS
Many previously unrecognized or poorly understood causes of Cushing's syndrome have been elucidated. It is now appreciated that essentially any form of exogenous glucocorticoid is capable of causing Cushing's syndrome. Additionally, new findings have led to a more complete understanding of bilateral nodular adrenal disease.


CONCLUSIONS
The diagnosis of patients with less profound cortisol excess has increased the prevalence of Cushing's syndrome and made nonpituitary causes more common. As a result, clinicians must be cognizant of such patients and pursue the diagnosis when appropriate.
Carroll
Ty B
TB
Endocrinology Center, Medical College of Wisconsin, W129 N7055 Northfield Drive, Building A, Suite 203, Menomonee Falls, WI 53051, USA. tcarroll@mcw.edu
Findling
James W
JW
D003480:Cushing Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005938:Glucocorticoids / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism
D005938:Glucocorticoids; D006854:Hydrocortisone