Abstract :
[en] Summary and Contextualization of “Cushing’s Disease in Humans” for the ESDV Workshop
This presentation on **Cushing’s disease in humans** was included in the ESDV workshop to provide a **comparative and translational perspective** after several species-specific lectures on hyperadrenocorticism.
The previous presentations addressed:
* **Therapy for hyperadrenocorticism in the dog** (R. Neiger)
* **Feline hyperadrenocorticism** (R. Neiger)
* **Equine Cushing’s disease** (L. Beco, K. Bergvall)
* **Hyperadrenocorticism in ferrets** (L. Beco)
Against this background, the human presentation served to place veterinary hyperadrenocorticism within a **broader biological and medical framework**, highlighting both shared mechanisms and important differences across species.
### Key Points from the Human Perspective
In humans, Cushing’s syndrome refers to the clinical consequences of **chronic cortisol excess**, while **Cushing’s disease** specifically denotes cases caused by a **pituitary ACTH-secreting adenoma**.
The presentation emphasized:
* **Clinical features**: central obesity, “moon face,” hypertension, diabetes, osteoporosis, neuropsychiatric disorders — many of which closely resemble signs seen in veterinary patients.
* **Etiological classification**:
* ACTH-dependent forms (mainly pituitary adenomas, ectopic ACTH)
* ACTH-independent forms (adrenal tumors, hyperplasia, iatrogenic causes)
* **Diagnostic approach in humans**:
* Biochemical confirmation (urinary free cortisol, ACTH, dexamethasone suppression, CRH test)
* Advanced localization techniques (pituitary MRI, inferior petrosal sinus sampling, PET scan)
* **Therapeutic strategies**:
* First-line: transsphenoidal pituitary surgery
* Alternatives: radiotherapy, medical treatment, bilateral adrenalectomy
### Relevance for Veterinary Dermatologists and Clinicians
In the context of the ESDV workshop, this human-focused presentation offered several benefits:
1. **Comparative insight**
It highlighted how hyperadrenocorticism represents a conserved endocrine disorder across species, with similar pathophysiological principles but different prevalences and dominant causes.
2. **Diagnostic inspiration**
Although many human diagnostic tools are not routinely available in veterinary medicine, they underline the importance of:
* Careful hormonal confirmation
* Differentiating pituitary-dependent vs adrenal-dependent disease
* Considering ectopic or atypical forms
3. **Therapeutic reflection**
Human reliance on surgery contrasts with the primarily medical management in small animals, encouraging reflection on:
* Why species differences exist
* When surgery might be appropriate or limited in veterinary patients
4. **One Health perspective**
By linking canine, feline, equine, ferret, and human hyperadrenocorticism, the session reinforced a **One Health approach**, showing how advances in one field can inform the others.
### Overall Conclusion
The presentation on **Cushing’s disease in humans** complemented the veterinary talks by:
* Providing a **comparative endocrinology framework**
* Enriching understanding of hyperadrenocorticism across species
* Encouraging veterinary clinicians to think beyond species boundaries when approaching diagnosis, pathophysiology, and treatment
It thus served as a valuable bridge between **human endocrinology and veterinary dermatology/endocrinology** within the ESDV workshop.
