EPIDEMIOLOGY OF CUSHINGS-SYNDROME AND SUBCLINICAL DISEASE

Cushing's syndrome resulting from either a pituitary or adrenal lesion is a relatively rare entity. A class of patients, characterized by abnormal biochemical regulation of the hypothalamo-pituitary-adrenal axis but no clinical manifestation of adrenal hyperfunction, has been described. This condition has been labeled subclinical or preclinical Cushing's syndrome. The optimal evaluation and treatment of this syndrome are unclear. The clinical epidemiology of Cushing's syndrome and its relationship to the subclinical and preclinical states are discussed and are used to suggest possible diagnostic and therapeutic strategies.