ACP Japan Chapter Facebook pageにMKSAPクイズが掲載されました。
The most common cause of Cushing syndrome is an elevated level of cortisol resulting from both endogenous and exogenous exposure to glucocorticoids. という事ですが、exogenous exposureの頻度は示されていません。まぁ、副腎皮質ステロイドの使われ方が多岐雑多で、あまりいい集計方法がないのかもしれません。
Table 25. Common Causes of Cushing Syndrome | |
cause | percentage of Patients with endogenous Cushing syndrome |
ACTH-dependent | 75-80 |
ACTH-secreting pituitary adenomas | 60-65 |
Ectopic ACTH secretion by tumors | 15-10 |
CRH-secreting tumors | <0.5 |
ACTH-independent | 20-25 |
Adrenal adenoma | 15-10 |
Adrenal carcinoma | 10-5 |
Exogenous Cushing syndrome | |
Administration of corticosteroids | |
Administration of drug with corticosteroid activity (progestational agents, such as megestrol acetate) |