{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T02:58:30Z","timestamp":1785207510200,"version":"3.55.0"},"reference-count":61,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>There is an increased awareness on the higher hypecoagulability risks in patients with Cushing's syndrome (CS), but management remains controversial. Here, we present 4 illustrative cases of CS that exemplify some \u201cgrey areas\u201d on venous thromboembolism (VTE) prevention\u2014when to start, how long to continue, what to use, and when to stop. The cases span the initiation of prophylaxis at diagnosis of active CS, periprocedural management around inferior petrosal sinus sampling, perioperative prophylaxis after transsphenoidal surgery (TSS), and discontinuation decisions in medically controlled disease. We synthesize current evidence and expert practice and recommend considering low-molecular-weight heparin at diagnosis of active CS, continuing through surgery, and extending for approximately 3 months after biochemical remission in selected patients to address the highest-events risk window. Based on recent data, we discourage routine use of graduated compression stockings (GCS) for VTE prevention. Though bleeding complications appear uncommon, they need to be carefully considered on an individualized basis. Finally, scenarios where prophylaxis can be safely discontinued once eucortisolaemia is achieved are outlined. This case-anchored framework translates heterogeneous data into actionable guidance and highlights priorities for prospective evaluation.<\/jats:p>","DOI":"10.1210\/clinem\/dgaf671","type":"journal-article","created":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T12:42:53Z","timestamp":1765716173000},"page":"e943-e950","source":"Crossref","is-referenced-by-count":1,"title":["Approach to the Patient with Cushing\u2019s Syndrome: Use of Anticoagulation Therapy"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1817-4597","authenticated-orcid":false,"given":"Kristina","family":"Isand","sequence":"first","affiliation":[{"name":"Department of Endocrinology, North Estonia Medical Centre , Tallinn 13419, Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9145-4304","authenticated-orcid":false,"given":"John","family":"Wass","sequence":"additional","affiliation":[{"name":"Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals , Oxford OX3 7LE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-0643","authenticated-orcid":false,"given":"Niki","family":"Karavitaki","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham , IBR Tower, Level 2, Birmingham B15 2TT, UK"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TT, UK"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9284-6289","authenticated-orcid":false,"given":"Maria","family":"Fleseriu","sequence":"additional","affiliation":[{"name":"Pituitary Center, Department of Medicine and Neurological Surgery, Oregon Health & Science University , Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-0754","authenticated-orcid":false,"given":"Frederikus A","family":"Klok","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Hemostasis, Leiden University Medical Center , 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1194-9866","authenticated-orcid":false,"given":"Alberto M","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Amsterdam University Medical Center, University of Amsterdam, and Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM) , Meibergdreef 9, 1105 AZ Amsterdam, The 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