Cushing syndrome

  • Cushing syndrome: suppressed ACTH production due to excess cortisol secretion from adrenal gland
  • following surgery: impaired endogenous cortisol production. Chronic atrophy from lack of ACTH stimulation
  • Give hydrocortisol following surgery and then taper
  • fludrocortisone not required
    • aldosterone secretion from contralateral adrenal gland not impacted
    • fludrocortisone required if bilateral adrenalectomy