EPIDEMIOLOGY OF CUSHINGS-SYNDROME AND SUBCLINICAL DISEASE

Cushing's syndrome resulting from either a pituitary or adrenal lesion is a relatively rare entity. A class of patients, characterized by ab normal biochemical regulation of the hypothalamo-pituitary-adrenal axi s but no clinical manifestation of adrenal hyperfunction, has been des cribed. This condition has been labeled subclinical or preclinical Cus hing's syndrome. The optimal evaluation and treatment of this syndrome are unclear. The clinical epidemiology of Cushing's syndrome and its relationship to the subclinical and preclinical states are discussed a nd are used to suggest possible diagnostic and therapeutic strategies.