July 6, 2009

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Cushing Syndrome (cont.)

Outlook

The outlook is favorable if surgery is curative.

The rare adrenal carcinomas are associated with a 5-year survival rate of 30% or less.

Two catastrophic medical crises that occur in corticosteroid excess states are perforated viscera (such as the stomach, duodenum, small intestine) and opportunistic saprophytic or fungal infections.

Exposure to excess corticosteroid results in multiple medical problems, including high blood pressure, obesity, osteoporosis, fractures, impaired immune function, impaired wound healing, glucose intolerance, and psychosis.

Exogenous steroids suppress the hypothalamic-pituitary-adrenal axis, with full recovery taking as long as a year after stopping corticosteroid medication. Thus, persons who are on or who have taken steroids are at risk for developing an adrenal crisis (a life-threatening condition caused by insufficient corticosteroid).



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