Cushing’s Syndrome is a rare endocrine disorder characterized by high levels of cortisol in the blood.
Cushing’s Syndrome is caused by chronic exposure of the body’s tissues to excess levels of cortisol – a hormone naturally produced by the adrenal gland. Pituitary adenomas, usually benign, secrete increased amounts of ACTH (Adrenocorticotropic hormone), a substance that controls the release of cortisol in that feedback loop. It typically causes an overproduction of cortisol. Tumors of the adrenal gland and ectopic ACTH producing tumors can cause similar problems with cortisol overproduction.
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Cushing’s Syndrome occurs when the body is exposed to high levels of cortisol for long periods of time.
Many people develop Cushing’s Syndrome because of glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation.
Some people develop Cushing’s Syndrome because of overproduction of cortisol by the body due to a pituitary adenoma which secretes excess ACTH, an adrenal adenoma which secretes excess cortisol, or an ectopic tumor which may secrete either ACTH or cortisol..
Most individuals affected experience moon face and central obesity. If they are children, they commonly experience slow growth rate. Skin infections, acne, slow healing, striae on the skin, and easy bruising also occur. Backache, bone pain and tenderness, fractures, and muscle weakness are also symptoms. In addition, a buffalo hump, or a mass of fat between the shoulders and above the collarbone, may form. Gender specific symptoms are excessive hair growth and irregular menstruation for women, and decreased libido and impotence for men. Other possible symptoms are mental changes, such as depression or anxiety, cognitive difficulties, fatigue, headache, hypertension, glucose intolerance, and more thirst and urination.
|Rapid weight gain||Rapid weight gain|
|Excess sweating||Excess sweating|
|Telangiectasia||Telangiectasia is the dilation of capillaries.|
|Severe fatigue||Severe fatigue|
|Striae||Striae are irregular areas of skin that look like bands, stripes, or lines.|
|Buffalo hump||Buffalo hump|
|High blood pressure||High blood pressure that is often hard to control even with medication|
|High blood sugars and/or insulin resistance||High blood sugars and/or insulin resistance|
|Altered diurnal rhythm||Altered diurnal rhythm|
|Secondary hypothyroidism||Secondary hypothyroidism|
|Low hormones||Low hormones such as FH, LSH, testosterone, growth hormone|
|Low vitamin D||Low vitamin D|
|Low ferritin||Low ferritin|
|Easy bruising||Easy bruising|
|Muscle, bone, and joint pain||Unexplained muscle, bone, and joint pain|
|Muscle weakness||Muscle weakness|
|Hirsutism||Hirsutism is increased facial hair/body hair|
|Loss of menstrual cycle and/or ovulation||Loss of menstrual cycle and/or ovulation|
|Loss of libido||Loss of libido|
|Loss of hair on head||Loss of hair on head|
|Difficulty when drawing blood||Difficulty when drawing blood|
A diagnosis is made with regards to the individual’s medical history, physical examination,, and laboratory tests. Extra tests are done, once Cushing’s syndrome has been diagnosed, to determine the cause of the excess cortisol production, be it inside the body or due to ingestion of cortisone.
Urine, blood, and saliva tests are used to measure hormone levels and determine whether or not excessive cortisol is being produced. A doctor can order other tests to pinpoint the cause of Cushing’s syndrome within the body. These tests may include the dexamethasone suppression test, which tests for excess production of ACTH caused by pituitary adenomas, the CRH stimulation test, which determines whether an individual has ectopic ACTH syndrome or cortisol-secreting adrenal tumors, and CT and MRI scans to visualize the pituitary and adrenal glands.
|Dexamethasone Suppression Test|
|24-Hour Urinary Measurement for Cortisol|
If Cushing’s syndrome is being caused by corticosteroid use, a doctor will decrease corticosteroid use. In the event that this is not possible, other symptoms will be managed.
If Cushing’s syndrome is being caused by a pituitary tumor, surgery, radiation, and cortisol replacement therapy may be required. In the case of an adrenal or other tumor, surgery may be required.
We don't have any treatments yet.
Tumor removal may lead to full recovery, or the condition may return. Cushing’s syndrome can be life-threatening if left untreated, and can result in diabetes, enlargement of the pituitary tumor, bone fractures, hypertension, kidney stones, and infections.
It is crucial for individuals with Cushing’s syndrome to not push themselves too hard physically, eat healthily, and monitor their mental health. Cognitive issues resulting from Cushing’s syndrome may improve through mental exercises such as Sudoku. Pain can be alleviated with low-impact exercise, hot baths, and massages.
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