27th May 2025

Complications

Complications of Cushing’s syndrome include adrenal insufficiency following surgery, due to adrenal suppression as described in the Secondary Adrenal Insufficiency chapter. This can necessitate replacement glucocorticoid therapy. 

Hypercortisolism also carries an increased risk of metabolic syndrome (diabetes mellitus, hypertension and obesity), cardiovascular disease, thrombophilia, osteoporosis and impaired immunity. 

Treatment-related complications include Nelson’s syndrome following bilateral adrenalectomy, where loss of adrenal feedback causes growth of pre-existing ACTH-secreting pituitary adenomas. Transsphenoidal pituitary resection can also cause deficiency of other pituitary hormones e.g. thyrotropin, somatotropin, desmopressin and androgens.