Cushing's Syndrome (Glucocorticoid Excess)

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and also include:

  • Symptoms of Glucocorticoid excess such as weight gain, fat distribution, hirsuitism, thin skin, bruising and striae
  • Other co-morbidities such as obesity, polycystic ovarian syndrome
  • Mental state, as depression may cause false positives on testing

Tests

  • U&E Cr eGFr
  • 24 hour urine free cortisol and/or 0800-0900 plasma cortisol after 1mg dexamethasone at 2300

Interim/GP management

To refer a patient with this condition, please see the Endocrinology clinic page for the full referral process and templates.

Similar symptoms can be caused by the use of exogenous glucocorticoids, ACTH-excreting pituitary adenoma, Ectopic ACTH secretion, adrenal adenoma or adrenal cancer.

For more information please see the Tasmanian Health Pathways website.

Semi-urgent / category 2

Suspected or proven endogenous Cushing's syndrome

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment