Should Hypercortisolism Be Part of Your Differential Diagnosis?

<h2>Abstract</h2> Endogenous hypercortisolism is a heterogeneous disease with wide-ranging clinical presentations, resulting from excess cortisol activity. Patients with hypercortisolism have increased risk of cardiometabolic morbidity and mortality, significantly impacting their quality of life and longevity. Data suggest that endogenous hypercortisolism is more prevalent than previously thought, especially in at-risk populations (eg, difficult-to-control diabetes despite standard-of-care therapy). The diagnosis of hypercortisolism is often delayed or missed, and thus it is imperative for advanced practice providers to gain a comprehensive understanding of the disease. This article reviews the disease spectrum and provides practical clinical guidance on incorporating hypercortisolism as a differential diagnosis.