Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, these high levels over a long period of time can cause several health problems.
Cushing's syndrome is caused by extended exposure to a hormone called cortisol. Prolonged or excess exposure to cortisol may be caused by: Long-term use of corticosteroid hormones such as cortisone or prednisone
Excess production of cortisol by:
Tumor or abnormality of the adrenal gland.
Tumor or abnormality of the pituitary gland. In the case of a
it is called Cushing's disease
Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland.
Pituitary and Adrenal Glands
Copyright © Nucleus Medical Media, Inc.
Symptoms may include: Weight gain of the upper body and trunkRounded faceHigh blood pressureSevere fatigue or muscle weaknessDiabetesEasily bruised, thinner skinPurple stretch marksExcess hair growth or acne in women
Menstrual disorders, especially infrequent or
absent periodsDiminished fertility and libidoPersonality changes or mood swings
Psychiatric changes such as
, or psychosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may be done to determine the level of cortisol and find a cause.
Tests for cortisol levels may include: 24-hour urinary free cortisol levelLate-evening cortisol saliva/blood levelDexamethasone suppression test
Tests to determine the cause of Cushing's Syndrome may include: Blood test for adrenocorticotropin hormone (ACTH) levelHigh-dose dexamethasone suppression testRarely, a CRH stimulation test
Other tests may help to see if there is a tumor on the pituitary or adrenal glands. Images may be taken with: MRICT scanChest x-ray
Treatment of Cushing's syndrome depends on the cause. Talk with your doctor about the best treatment plan for you. Options include: Surgical removal of tumorSurgical removal of part, all, or both adrenal glandsRadiation therapy
for some persistent tumors
Gradual withdrawal of cortisone-type drugs under close medical supervisionDrugs that decrease cortisol production or block the functioning of other adrenal products
Work with your doctor to keep use of corticosteroid drugs to a minimum.
Arnaldi G, Angeli A, Atkinson AB, Bertagna X, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement.
J Clin Endocrinolo Metabo
Diez JJ, Iglesias P. Pharmacological therapy of Cushing’s syndrome: drugs and indications.
Mini Rev Med Chem
Kirk LF Jr, Hash RB, Katner HP, Jones T. Cushing's disease: clinical manifestations and diagnostic evaluation.
Am Fam Physician
. 2000;62(5):1119-1127, 1133-1134.
Tritos NA, Biller BM, Swearingen B; Medscape. Management of Cushing disease.
Nat Rev Endocrinol
Makras P, Toloumis G, Papadoglas D, et al. The diagnosis and differential diagnosis of endogenous Cushing’s syndrome.
Last reviewed May 2013 by Kim Carmichael, MD; Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.