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Cushing's Syndrome vs Addison's Disease

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Bone Health

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Cushing's can lead to osteoporosis and increased fracture risk; bone complications in Addison's are less directly related.

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Sex Hormone Effects

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Cushing's can lead to hirsutism and menstrual irregularities in women; Addison's does not typically cause excess hair growth but can alter menstrual cycles.

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Blood Pressure

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Cushing's often results in hypertension, while Addison's can lead to hypotension.

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Treatment

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Cushing's may require surgery, radiation, or medication to lower cortisol; Addison's treatment involves hormone replacement.

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Metabolic Complications

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Cushing's can lead to diabetes and dyslipidemia; Addison's can cause hypoglycemia and hyponatremia.

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Incidence

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Cushing's syndrome is less common than Addison's disease in the general population.

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Psychiatric Manifestations

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Cushing's can cause mood swings, depression, and irritability; Addison's may be associated with depression and cognitive changes.

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Skin Manifestations

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Thinning of the skin and easy bruising are common in Cushing's, while Addison's can cause darkening of skin creases and scars.

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Adrenal Gland Size

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Cushing's may cause adrenal hyperplasia or tumors, leading to enlargement; Addison's often involves adrenal atrophy or damage.

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Immune System

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Cushing's causes immunosuppression; Addison's does not directly suppress the immune system.

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Stress Response

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Patients with Cushing's can handle stress poorly due to excessive cortisol; Addison's patients may suffer from adrenal crisis under stress.

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Etiology

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Cushing's is often caused by overproduction of cortisol or prolonged use of corticosteroids, whereas Addison's is due to adrenal insufficiency.

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Electrolyte Balance

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Cushing's tends to have hypokalemia; Addison's disease generally presents with hyperkalemia.

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Hormone Levels

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Cushing's exhibits high cortisol levels, Addison's presents with low cortisol and often aldosterone levels.

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Common Symptoms

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Cushing's features weight gain, moon face, and buffalo hump; Addison's involves weight loss, fatigue, and hyperpigmentation.

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Diagnostic Tests

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Cushing's diagnosis may include 24-hour urinary free cortisol test and dexamethasone suppression test; Addison's relies on ACTH stimulation test and serum electrolytes.

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