51. The significance of the concentrations of cortisol and cortisone in saliva

Abstract

The chronic exposure to excessive concentrations of circulating glucocorticoids, or hypercortisolism, determines a severe disease named Cushing׳s syndrome (CS). Adrenocorticotropic hormone-secreting pituitary tumors induce adrenal cortisol hypersecretion and represent the most frequent form (around 70%) of endogenous CS. This serious endocrine disorder is known as Cushing׳s disease (CD). This article reviews the clinical features of CD and the diagnostic algorithm to establish the diagnosis of endogenous hypercortisolism, named CS, and, subsequently, to differentiate between pituitary (CD) and non-pituitary (ectopic and adrenal) causes of CS. Finally, currently available therapeutic approaches, including surgery, radiotherapy and medical therapy, are illustrated.