Pseudo-Cushing

Q: Patients with physiologic hypercortisolism are more prone to have proximal muscle atrophy and weakness.

A) True 

B) False

Answer: B

When hypercortisolism occurs in any disorder other than Cushing syndrome, it is called physiologic or pseudo-Cushing syndrome. These patients usually are spared of some cardinal signs of true Cushing syndrome, such as easy bruising, thinning, friability) or proximal muscle atrophy and weakness.

Some well-known conditions/disorders causing physiologic hypercortisolism and Cushing syndrome are:

• Pregnancy
• Severe obesity
• Polycystic ovary syndrome (PCOS)
• Psychological stress
• Poorly controlled diabetes mellitus
• Chronic alcoholism, particularly during withdrawal
• Severe illness
• Obstructive sleep apnea
• Intense chronic exercise
• Hypothalamic amenorrhea

#endocrinology

References:

1. Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing's syndrome: a consensus statement. J Clin Endocrinol Metab 2003; 88:5593.

2. Chabre O. The difficulties of pseudo-Cushing's syndrome (or "non-neoplastic hypercortisolism"). Ann Endocrinol (Paris). 2018 Jun;79(3):138-145. doi: 10.1016/j.ando.2018.04.017. Epub 2018 Apr 30. PMID: 29716734.

3. Pecori Giraldi F, Ambrogio AG. Pseudo-Cushing - A Clinical Challenge? Front Horm Res. 2016;46:1-14. doi: 10.1159/000443859. Epub 2016 May 17. PMID: 27211794.