CUSHING'S SYNDROME

 Basic information

description

Cushing's syndrome is due to excess levels of cortisol, a hormone. Cortisol helps the body respond to stress and change. The adrenal glands (located over the kidneys) and pituitary gland (at the base of the brain) are involved in the production of cortisol. Cushing's syndrome most often affects adults ages 20 to 50.

FREQUENT SIGNS & SYMPTOMS

• Round (moon-like) face and puffy eyes.
• Thin, fragile skin; easy bruising.
• Weakness.
• Weight gain. Fat deposits, such as around the torso and the back of the neck.
• Growth of facial hair in women.
• Stretch marks (red/blue streaks on the skin).
• Mental, mood, and emotional changes.
• Menstrual changes (increase, irregular, or no period).
• More likely to get infections. High blood pressure.
• Sexual and fertility problems.
• Children may have growth retardation, acne, or very early or very late puberty.

causes

• It may result from an overproduction of cortisol by the adrenal glands due to a variety of medical disorders.
• It may result from long-term use of cortisol-like drugs (steroid hormones) to treat medical disorders (such as asthma, arthritis, and inflammatory bowel disease).

risk increases with

• An abnormal growth in the pituitary gland. This causes production of excessive ACTH (adrenocorticotropic hormone). This in turn stimulates the adrenal glands to secrete hormones. This is called Cushing's disease.
• A benign or cancerous tumor in the adrenal gland.
• Tumors in other places in the body produce hormones that in turn cause the adrenal glands to produce excess cortisol.
• Prolonged use of steroid hormone drugs.

PREVENTIVE MEASURES

If steroid hormone drugs are prescribed, take the lowest dose possible for the shortest time.

expected outcomes

Outcome will depend on the cause of Cushing's syndrome, the degree of excess cortisol, the length of the disease, and the person's basic health. If the cause is treatable, the symptoms may resolve in 2 to 18 months.

possible complications

• Osteoporosis, which can lead to bone fractures.
• Side effects of steroid hormones.
• Diabetes, high blood pressure, infections, kidney stones, or spread of cancerous tumors.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and drug use. Medical tests may include studies of blood and urine to measure hormone levels, pituitary gland and adrenal gland function tests, and CT, MRI, or x-rays.
• Treatment will depend on the cause of the disorder.
• If it is due to steroid hormone use, the dosage may be slowly reduced (depending on the disease being treated). If the steroid hormone needs to be continued, other drugs may be taken to control the side effects.
• Pituitary gland tumors may be treated with surgery or radiation. If the pituitary gland is removed, hormone replacement therapy will be needed for life.
• Adrenal gland adenoma tumors are removed with surgery. The other adrenal gland is left in place and will eventually take over hormone production.
• Adrenal gland cancerous tumors can be cured if diagnosed early. Often, they are not diagnosed until they have spread beyond the adrenal gland. When this happens, they are not curable. Drugs can treat symptoms.
• Tumors in other places in the body may be treated with surgery, radiation, or chemotherapy. This may help improve the Cushing's syndrome.
• Wear a medical alert type bracelet or pendant indicating your medical problem and the drugs you take.

medications

• Drugs to suppress adrenal gland function, cortisone drugs (if adrenal gland removed), or drugs to replace pituitary hormones may be prescribed.
• Drugs to lower blood pressure, to prevent bone loss, and to reduce blood sugar may be prescribed.

activity

No limits. Energy will improve once treatment begins.

diet

No special diet, unless otherwise advised.

 notify our office if

• You or a family member has symptoms of Cushing's syndrome.
• Signs of infection occur or other symptoms develop.

Special Notes: