Cushing Vs Addison Clinical Comparison

Cushing syndrome is chronic cortisol excess. It may result from excess ACTH stimulation, such as a pituitary adenoma causing Cushing disease or an ectopic ACTH-secreting tumor. It may also arise from an adrenal tumor producing cortisol independently of ACTH. Long-term glucocorticoid exposure can create a Cushingoid appearance and must be excluded before testing for endogenous disease. Addison disease is primary adrenal insufficiency: destruction of the adrenal cortex, most often from autoimmune disease, causes deficient cortisol and aldosterone production. The contrast follows hormone physiology. Cortisol supports vascular tone, glucose availability, and the stress response. Too much cortisol promotes hyperglycemia, hypertension, protein breakdown, infection risk, and bone loss. Too little cortisol leaves the patient unable to maintain blood pressure, glucose, or an adequate response to illness. Aldosterone retains sodium and water while promoting potassium excretion. Aldosterone deficiency in Addison disease causes sodium loss, volume depletion, hypotension, and hyperkalemia. Aldosterone is usually not deficient in Cushing syndrome.