Cushing syndrome
Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.
Causes
The most common cause of Cushing syndrome is taking too much glucocorticosteroid medicine. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body’s natural hormone cortisol. These drugs are used to treat conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, rheumatoid arthritis.
Other people develop Cushing syndrome because their bodies produce too much cortisol. This hormone is made in the
adrenal glands.
Causes of too much cortisol are:
Cushing disease
, which occurs when the pituitary gland makes too much of the hormone ACTH. ACTH then signals the adrenal glands to produce too much cortisol. A pituitary gland tumor can cause this condition.
Tumor of the adrenal gland
Tumor elsewhere in the body that produces corticotropin-releasing hormone
Tumors elsewhere in the body that produce
ACTH
(
ectopic Cushing syndrome
)
Symptoms
Most people with Cushing syndrome will have:
Round, red, full face (
moon face
)
Slow growth rate in children
Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity)
Skin changes that are often seen:
Skin infections
Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
Thin skin with easy bruising
Muscle and bone changes include:
Backache, which occurs with routine activities
Bone pain or tenderness
Collection of fat between the shoulders and above collar bone
Rib and spine fractures caused by thinning of the bones
Weak muscles, especially of the hips and shoulders
Women with Cushing syndrome often have:
Excess hair growth on the face, neck, chest, abdomen, and thighs
Periods that become irregular or stop
Men may have:
Decreased or no desire for sex
Impotence
Other symptoms that may occur with this disease:
Mental changes
, such as depression, anxiety, or changes in behavior
Fatigue
Headache
Increased thirst and urination
Exams and Tests
The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months.
Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are:
Blood
cortisol levels
Blood sugar
Saliva cortisol levels
Dexamethasone suppression test
24-hour urine for
cortisol
and
creatinine
ACTH level
ACTH stimulation test
Tests to determine the cause or complications may include:
Abdominal CT
ACTH
Pituitary
MRI
Bone mineral density
Treatment
Treatment depends on the cause.
Cushing syndrome caused by corticosteroid use
:
Your doctor will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous.
If you cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or
osteoporosis
should be closely monitored.
With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need:
Surgery to remove the tumor.
Radiation after removal of a pituitary tumor in some cases.
Cortisol replacement therapy after surgery and possibly for the rest of your life.
With Cushing syndrome due to an
adrenal tumor
or
other tumors
:
You may need surgery to remove the tumor.
If the tumor cannot be removed, you may need medicines to help block the release of cortisol.
Outlook (Prognosis)
Removing the tumor may lead to full recovery, but there is a chance that the condition will return.
Survival for people with ectopic tumors depends on the tumor type. Untreated, Cushing syndrome can be life-threatening.
Possible Complications
Diabetes
Enlargement of pituitary tumor
Fractures
due to osteoporosis
High blood pressure
Kidney stones
Serious infections
When to Contact a Medical Professional
Call your health care provider if you have symptoms of Cushing syndrome.
Prevention
If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.
Alternative Names
Hypercortisolism; Cortisol excess
◄ BACK
Secure Patient Login
View Practice Forms
Accessible Version
Integrated Patient Portal ©
WRS Health