title: [Prevalence, etiology and clinical findings of Cushing's syndrome].
abstract: Endogenous Cushing's syndrome is a very rare entity, with an incidence of 2-4 cases per million inhabitants per year. Cases caused by ectopic ACTH secretion are under-diagnosed. Cushing's disease is the most frequent cause of endogenous Cushing's syndrome, which is 5 or 6 times more frequent than adrenal Cushing's syndrome, with an incidence of between 1.2 and 2.4 cases per million inhabitants per year. Cushing's disease is 3-8 times higher in women than in men. The frequency of adrenal tumors is 3 times higher in women, while that of Cushing's syndrome due to adrenal tumors is 3-5 times higher. Age at diagnosis of Cushing's syndrome varies according to the etiology. Most cases of Cushing's disease are due to a pituitary adenoma, although the tumor may not be visible on the available imaging techniques. ACTH-independent Cushing's syndrome is found in 20% of cases and is most frequently due to adenomas (10%) or adrenal carcinomas (8). Bilateral micronodular hyperplasia and macronodular hyperplasia are infrequent entities, representing less than 10% of all cases of ACTH-independent Cushing's syndrome. Both familial and sporadic forms exist: the familial form, or Carney complex, and ACTH-independent bilateral macronodular hyperplasia, in which the size of the adrenal glands is considerably enlarged. The signs and symptoms of Cushing's syndrome are a direct result of long-term exposure to excessive glucocorticoids. Most signs and symptoms are highly prevalent in the general population (hypertension, central obesity, diabetes mellitus or carbohydrate intolerance, osteoporosis, and characteristic phenotypical alterations).
authors.affiliation: Servicio de Endocrinología, Hospital Ramón y Cajal, Madrid, España. marcos.lahera@salud.madrid.org
authors.forename: Marcos
authors.initials: M
authors.lastname: Lahera Vargas
authors.forename: César Varela
authors.initials: CV
authors.lastname: da Costa
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000150:complications; D000236:Adenoma / Q000150:complications / Q000378:metabolism; D000302:Adrenal Cortex / Q000473:pathology; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000378:metabolism; D002277:Carcinoma / Q000150:complications / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003480:Cushing Syndrome / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006965:Hyperplasia; D015994:Incidence; D008297:Male; D010641:Phenotype; D047748:Pituitary ACTH Hypersecretion / Q000150:complications; D010911:Pituitary Neoplasms / Q000150:complications / Q000378:metabolism; D015995:Prevalence; D012306:Risk
chemical_list: D005938:Glucocorticoids; D006854:Hydrocortisone