Cushing's Syndrome in Women With Polycystic Ovaries and Hyperandrogenism

P. Gerry Fegan; Derek D. Sandeman; Nils Krone; Deborah Bosman; Peter J. Wood; Paul M. Stewart; Neil A. Hanley


Nat Clin Pract Endocrinol Metab. 2007;3(11):778-783. 

In This Article


The Rotterdam Consensus Statement establishes criteria for the diagnosis of PCOS only when other etiologies have been excluded. The importance of this caveat is illustrated by the presented case and three additional reported cases, in each of which Cushing's syndrome was missed. Recent data obtained by screening individuals with type 2 diabetes suggest that cortisol excess, widely considered a rare endocrinopathy in the form of classical Cushing's syndrome, is in fact more common than supposed. As economic pressures drive health care to be delivered within fewer consultation sessions outside of specialist centers, it is pertinent to emphasize that not all cases of hyperandrogenism or ovarian cysts are related to PCOS and that curable causes, such as Cushing's syndrome, must be excluded by careful history taking, examination and (potentially repeated) investigation.

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