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Cushing's Syndrome vs Addison's Disease
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Etiology
Cushing's is often caused by overproduction of cortisol or prolonged use of corticosteroids, whereas Addison's is due to adrenal insufficiency.
Hormone Levels
Cushing's exhibits high cortisol levels, Addison's presents with low cortisol and often aldosterone levels.
Common Symptoms
Cushing's features weight gain, moon face, and buffalo hump; Addison's involves weight loss, fatigue, and hyperpigmentation.
Blood Pressure
Cushing's often results in hypertension, while Addison's can lead to hypotension.
Electrolyte Balance
Cushing's tends to have hypokalemia; Addison's disease generally presents with hyperkalemia.
Skin Manifestations
Thinning of the skin and easy bruising are common in Cushing's, while Addison's can cause darkening of skin creases and scars.
Psychiatric Manifestations
Cushing's can cause mood swings, depression, and irritability; Addison's may be associated with depression and cognitive changes.
Treatment
Cushing's may require surgery, radiation, or medication to lower cortisol; Addison's treatment involves hormone replacement.
Metabolic Complications
Cushing's can lead to diabetes and dyslipidemia; Addison's can cause hypoglycemia and hyponatremia.
Diagnostic Tests
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.
Incidence
Cushing's syndrome is less common than Addison's disease in the general population.
Bone Health
Cushing's can lead to osteoporosis and increased fracture risk; bone complications in Addison's are less directly related.
Adrenal Gland Size
Cushing's may cause adrenal hyperplasia or tumors, leading to enlargement; Addison's often involves adrenal atrophy or damage.
Sex Hormone Effects
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.
Immune System
Cushing's causes immunosuppression; Addison's does not directly suppress the immune system.
Stress Response
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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