Abordaje diagnóstico del síndrome de cushing en el primer nivel de atención en Ecuador

Abstract

INTRODUCTION: The excess in the production of cortisol triggers systemic repercussions that make up Cushing's syndrome, its diagnosis constitutes a challenge for physicians present in the first level of care due to its rarity and high complexity. OBJECTIVE: To describe the most relevant clinical and laboratory aspects for Cushing's Syndrome diagnosis in Ecuador through an exhaustive bibliographic review that includes mostly articles from high-impact journals published in the last 5 years so that medical personnel present at the first level make effective referrals to more complex health centers. MATERIALS AND METHODS: A bibliographic review is carried out, selecting those publications from the last 5 years of articles such as systematic review, commentary, clinical practice guidelines, case reports, meta-analysis and controlled clinical trials through the PubMed platform. OBSERVATIONS: Cushing's syndrome is a rare clinical entity of multifactorial etiology that presents a high morbidity and mortality rate, its clinical presentation varies depending on the severity and time of exposure to excess plasma cortisol and is confirmed with laboratory tests that are not available. in the first level of care in Ecuador. CONCLUSION: It is necessary for the primary health care physician to recognize the typical and atypical clinical manifestations of excess cortisol since laboratory tests to diagnose Cushing's syndrome are not available at the primary level of care in Ecuador.