Cushing's Syndrome Pathophysiology, Diagnosis and Treatment
Cushing´s syndrome is a relatively rare clinical disorder that is associated with many co-morbidities such as systemic hypertension, diabetes, osteoporosis, impaired immune function and growth impairment in children, all of which severely reduce quality o
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Marcello D. Bronstein Editor
Cushing’s Syndrome Pathophysiology, Diagnosis and Treatment
CONTEMPORARY ENDOCRINOLOGY
Series Editor: P. Michael Conn, PhD Oregon Health & Science University Beaverton, OR
For other titles published in this series, go to www.springer.com/series/7680
Marcello D. Bronstein Editor
Cushing’s Syndrome Pathophysiology, Diagnosis and Treatment First Edition
Editor Marcello D. Bronstein Division of Endocrinology and Metabolism Hospital das Clínicas University of Sao Paulo Medical School Sao Paulo Brazil [email protected]
ISBN 978-1-60327-448-7 e-ISBN 978-1-60327-449-4 DOI 10.1007/978-1-60327-449-4 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2010937016 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Humana Press is part of Springer Science+Business Media (www.springer.com)
Preface I usually say to my residents that when I was a resident myself, I was much more confident at diagnosing and treating Cushing’s syndrome than I am today! This statement aims at pointing out that the deeper you go in dealing with clinical, laboratorial, and image aspects of the differential diagnosis of the many etiologies of the syndrome, as well as the various treatment modalities, the more you will encounter cases that are exceptions to the rules, leading to diagnosis and treatment pitfalls. However, notwithstanding that, only insights provided by experts will help physicians dealing with Cushing’s syndrome to provide better care to their patients, avoiding the above-mentioned pitfalls. This medical text, which Humana Press kindly invited me to edit, was initially intended to be a handbook on Cushing’s syndrome, giving insights on the various aspects of its diagnosis and treatment to trainee endocrinologists, internists, pediatricians, neurosurgeons, and urologists. Pursuing that task, I invited basic and clinical researchers with great experience in their respective areas, and I was gratified by their agreement to cooperate with the book. However, their chapters were so comprehensive and profound that I ended up with a true textbook on Cushing’s syndrome, from the bench to bedside, encompassing molecular, physiological, clinical, and therapeutic aspects of all the many causes of hypercortisolism. As many c
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