Síndrome de Cushing

Abstract

En el año 1932. Cushing, dio autonomía a un síndrome pluriglandular endocrino, que denominó basofilismo pituitario caracterizado por un cuadro clínico, en el que se destaca principalmente, un estado de virilización en la mujer y de feminización en el hombre, acompañado de obesidad, diabetes, hipertensión, policitemia y alteraciones óseas. Lo consideró como consecuencia de una adenoma basofilo de la hipófisis, si bien actualmente se acepta, que puede ser originado por lesiones corticosurrénales y tímicas. Más frecuente en la mujer que en el hombre, se traduce en aquélla por una fase de precocidad sexual y temprana aparición menárquica, seguida de virilismo y amenorrea, mientras que en los hombres, la esfera genital acusa impotencia y atrofia testicular.

The author establishes the “clinical individuality” of Cushing’s Syndrome with its cardinal symptomatology: regional obesity, dysmenorrhea, osteoporosis, arterial hypertension and hirsutism; but he remarks the “non etiological individuality”, since that the syndrome may be present out of the anatomopathological chart of hypophysial basophilism provided that it has been pointed out in the chromophobus adenoma, in the cortical suprarrenal syndrome in the ovario one and in the thymic. Clinically, the differential diagnosis among the many etiologic causais which may give the origin to the syndrome, is not always easy and has of course, a great importance to begin and adequated treatment, since that it must be directed to the causal which has given it the origin. This syndrome mey be produced by a pluriglandular endocrine disorder, with a prevailing expression, it may be phypophysial or corticalsuprarrenal. By its neuro-endocrine connection, it must be included among neurovegetative disorders where “vegetative brain” or diencephalon acts actively. The author establishes the evolution, the clinical forms and the differential diagnosi and he finishes with the treatment, proclaiming the radiological and the endocrine one.