#AACE2021: Top 20-Cyclical Cushing Syndrome

Video Transcription

Video Summary

In this video, Dr. Glynette Nieman, a senior investigator at the National Institute of Health, discusses cyclic Cushing syndrome. She describes the definition of cyclic Cushing syndrome as periods of intermittent hypercortisolism alternating with periods of eucortisolism. She explains that the duration of eucortisolism and hypercortisolism can vary, but the median duration is approximately 30 days for eucortisolism and 21 days for hypercortisolism. Dr. Nieman emphasizes the importance of taking a detailed history to identify patients who may have cyclic Cushing syndrome and mentions that the onset and offset of hypercortisolism and eucortisolism can be gradual or rapid.<br /><br />She discusses the clinical and laboratory presentations of cyclic Cushing syndrome and the challenges in diagnosing the condition. Dr. Nieman mentions that the late-night salivary cortisol test is more sensitive for detecting cyclic Cushing syndrome compared to the urine-free cortisol test. She emphasizes the need to test for hypercortisolism during periods of symptoms and provides strategies for determining the appropriate testing intervals based on the frequency of cycles. Dr. Nieman also discusses the differential diagnosis of cyclic Cushing syndrome, including factitious Cushing syndrome and glucocorticoid resistance.<br /><br />Overall, this video provides an overview of cyclic Cushing syndrome and highlights the challenges in diagnosing and managing this condition.

Asset Subtitle

Lynnette Nieman, MD, FACP | Adriana G. Ioachimescu, MD, PhD, FACE

Keywords

Dr. Glynette Nieman

cyclic Cushing syndrome

intermittent hypercortisolism

eucortisolism

duration of eucortisolism

duration of hypercortisolism

detailed history

late-night salivary cortisol test

diagnosis of cyclic Cushing syndrome