Cushing's Info

A pituitary tumor is an abnormal growth in the pituitary gland, the part of the brain that regulates the body's balance of hormones.

The pituitary gland is a pea-sized endocrine gland located at the base of the brain. The pituitary regulates and controls the release of hormones from other endocrine glands, which in turn regulate many body processes. These hormones include:

• Adrenocorticotropic hormone (ACTH)
• Growth hormone (GH)
• Prolactin
• Thyroid-stimulating hormone (TSH)

Q. I am a third-year medical student doing a rotation in endocrinology. A patient I saw recently has type 2 diabetes, absence of menses, high cholesterol, hypothyroid, hypertension and obesity (especially in the upper body). She was tested for Cushing's, which showed a slightly elevated level of cortisol, but it was within normal range. Is it possible to have Cushing's if the level is still within normal range? What are other indicators of this disease? Are there other diagnoses to consider?

1. Cushing’s syndrome
This is due to excessive glucocorticoid hormones (cortical). This can also occur due to excessive corticosteroid administration. That is, both endogenous and exogenous cortisols can cause cushings. The clinical features are:
• Wasting of tissue myopathy (weak muscles); thin skin, osteporosis, purple abdominal striations.
• Water retention oedema, high BP.
• Obesity of trunk, head, neck.
Apart from there they will be excessively prone to infection; poor wound healing, hirsuitism (hair growth in women).

Robin writes at http://survivethejourney.blogspot.com/2009/07/patients-first-twitter-transcript.html

From the first tweet by Dr. Val...

Medbloggers and congressman discuss healthcare reform at the National Press Club today 9am-12pm ET. Follow #patientsfirst for live coverage.

....to the multitude of tweets from participants and the audience, it was an intense and vibrant conversation. The tweets of those on Twitter were in the background as those on the panel gave their responses.

I missed it. I was working and couldn't watch. But I wanted to read the thread as it happened, in the order it happened. So I compiled it and here it is for those of you who missed it or want to read what others had to say.

To those who participated and/or tweeted, I want to say a great big "THANK YOU!!"