Hyperadrenocorticism (Cushing's disease) can result in permanent impairment that can be quantified using the AMA criteria.
The syndrome may arise with disorders of the:
(1) pituitary adenoma
(2) adrenocortical hyperplasia, adenoma or carcinoma
(3) treatment with glucocortiosteroids
Parameters:
(1) signs and symptoms
(2) cause for the hyperfunction
Signs and symptoms of hyperfunction:
(1) "moon" facies
(2) truncal obesity with "buffalo hump"
(3) muscle wasting and weakness
(4) skin atrophy
(5) poor wound healing
(6) easy bruisability
(7) abdominal striae
(8) hypertension
(9) osteoporosis
(10) glucose intolerance
(11) menstrual irregularities in women
(12) growth retardation in children
Signs and Symptoms |
Cause |
Impairment of the Whole Person |
none |
short term low dose glucocorticoid therapy |
0% |
minimal |
surgically removable pituitary or adrenal adenoma; moderate dose glucocorticoid therapy |
0 - 14% |
moderate |
bilateral adrenal hyperplasia; unresectable pituitary or adrenal adenoma; high doses glucocorticoid therapy |
15 – 39% |
severe |
metastasizing carcinoma |
>= 40%; depends on end-organ damage |
where:
• Impairment with a metastasizing adrenocortical carcinoma would be based on the involvement of other sites.
Specialty: Sports Medicine & Rehabilitation, Endocrinology