Complications of Cushing's Syndrome: State of the Art

    May 2016 in “ ˜The œLancet. Diabetes & endocrinology ”
    Rosario Pivonello, Andrea M. Isidori, Maria Cristina De Martino, John Newell‐Price, Beverly M. K. Biller, Annamaria Colao
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    TLDR Cushing's syndrome can cause serious health problems, and early treatment is crucial, but some issues may remain after treatment.
    The document from 2016 details the various complications of Cushing's syndrome, including increased mortality and morbidity due to cardiovascular diseases, metabolic syndrome, musculoskeletal disorders, neuropsychiatric issues, reproductive and sexual dysfunction, and dermatological problems. It underscores the importance of early treatment to manage cortisol excess and comorbidities to prevent serious complications and reduce mortality. However, it also notes that some health issues, such as hypertension, metabolic abnormalities, and bone and muscle damage, may persist even after successful treatment. The paper reviews the pathophysiology of these complications and the impact of treatments like pasireotide, which can worsen glycemic control. It also discusses the need for careful management of conditions like hypokalemia, immunosuppression, and haemostatic abnormalities. The document calls for more research to guide clinical care and to understand why some complications persist after remission and why there is variability in patient outcomes.
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