Causes of Cushings Syndrome ACTH-dependent Cushings disease(acTH-producing pituitary adenoma)(60-70%) Ectopic ACTH syndrome(15-20%) Ectopic CRH syndrome Macronodular adrenal hyperplasia latrogenic( treatment with ACTH 1-24) ACTH-independent Adrenal adenoma(10-20%)and carcinoma (<5%) Primary pigmented nodular adrenal hyperplasia and Carney's syndrome McCune-Albright syndrome Aberrant receptor expression(gastric inhibitory polypeptide, interleukin-1B) (ACTH-independent macronodular hyperplasia latrogenic(e.g, pharmacologic doses of prednisolone, dexamethasone)Causes of Cushing’s Syndrome • ACTH-dependent • Cushing's disease (ACTH-producing pituitary adenoma) (60-70%) • Ectopic ACTH syndrome (15-20%) • Ectopic CRH syndrome • Macronodular adrenal hyperplasia • Iatrogenic (treatment with ACTH 1-24) • ACTH-independent • Adrenal adenoma (10-20%) and carcinoma (<5%) • Primary pigmented nodular adrenal hyperplasia and Carney's syndrome • McCune-Albright syndrome • Aberrant receptor expression (gastric inhibitory polypeptide, interleukin-1β) (ACTH-independent macronodular hyperplasia ) • Iatrogenic (e.g., pharmacologic doses of prednisolone, dexamethasone)