Aspectos clínicos e laboratoriais no diagnóstico diferencial da síndrome de cushing
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Data
2022-12-06
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso fechado
Editora
Autores
Gonçalves, Yasmin
Duarte, Dayane
Assis, Lorena
Reis, Noemi
Filaretti, Ana
Louredo, Raquel
Orientador
Martins, Suellen
Coorientador
Verônica, Lara
Resumo
A Síndrome de Cushing (SC) é uma doença causada pela exposição do nosso corpo a níveis altos de cortisol, refletindo numa variedade de sinais e sintomas. A SC pode ser classificada em dois tipos: endógena e exógena, de acordo com seu mecanismo de ação. A endógena se divide em ACTH-dependente e ACTH-independente, logo a exógena é causada pelo uso exagerado de glicocorticóides, apresentando o tipo mais comum e de fácil tratamento. O diagnóstico da SC endógena, representa um desafio, requerendo conhecimento adequado da regulação hormonal do eixo hipotálamo-hipófise-adrenal (HHA), aplicação precisa de testes funcionais que estimulam ou inibem este eixo e a indicação de exames bioquímicos e de imagem resolutivos para as diversas etiologias investigadas. Os resultados laboratoriais devem ser interpretados em conjunto com as manifestações clínicas e os achados radiológicos. Foi realizada uma revisão bibliográfica em base de dados: Scielo, Pubmed, Lilacs e The Lancet. O presente estudo tem o objetivo de contextualizar, através de uma revisão bibliográfica da literatura, o diagnóstico clínico e laboratorial da SC, contemplando suas particularidades e desafios.
Cushing's Syndrome (CS) is a disease caused by the exposure of our body to high levels of cortisol, reflecting in a variety of signs and symptoms. CS can be classified into two types: endogenous and exogenous, according to its mechanism of action. The endogenous is divided into ACTH-dependent and ACTH-independent, so the exogenous is caused by the exaggerated use of glucocorticoids, presenting the most common and easy-to-treat type. The diagnosis of endogenous CS represents a challenge, requiring adequate knowledge of the hormonal regulation of the hypothalamic-pituitary-adrenal axis, precise application of functional tests that stimulate or inhibit this axis and the indication of resolving biochemical and imaging tests for the various investigated etiologies. Laboratory results must be interpreted in conjunction with clinical manifestations and radiological findings. A bibliographic review was carried out in the following databases: Scielo, Pubmed, Lilacs and The Lancet. The present study aims to contextualize, through a literature review, the clinical and laboratory diagnosis of CS, contemplating its particularities and challenges.
Cushing's Syndrome (CS) is a disease caused by the exposure of our body to high levels of cortisol, reflecting in a variety of signs and symptoms. CS can be classified into two types: endogenous and exogenous, according to its mechanism of action. The endogenous is divided into ACTH-dependent and ACTH-independent, so the exogenous is caused by the exaggerated use of glucocorticoids, presenting the most common and easy-to-treat type. The diagnosis of endogenous CS represents a challenge, requiring adequate knowledge of the hormonal regulation of the hypothalamic-pituitary-adrenal axis, precise application of functional tests that stimulate or inhibit this axis and the indication of resolving biochemical and imaging tests for the various investigated etiologies. Laboratory results must be interpreted in conjunction with clinical manifestations and radiological findings. A bibliographic review was carried out in the following databases: Scielo, Pubmed, Lilacs and The Lancet. The present study aims to contextualize, through a literature review, the clinical and laboratory diagnosis of CS, contemplating its particularities and challenges.
Palavras-chave
Síndrome de Cushing, Doença de cushing, diagnóstico, hipercortisolismo endógeno, cortisol