Author: Vanessa Ngan, Staff Writer, 2005.
Cushing syndrome is a hormonal disorder caused by prolonged exposure to inappropriately high levels of plasma glucocorticoid (also referred to as cortisol) hormones. Glucocorticoid hormones maintain glucose regulation, suppress the immune response and are released as part of the body's response to stress. The production of cortisol from within the cortex of the adrenal glands is regulated by a small gland just below the brain called the pituitary gland.
There are several causes of Cushing syndrome:
The most common cause of Cushing syndrome is from the use of exogenous glucocorticoids for periods of several months or longer.
Cushing syndrome caused by an adrenal or pituitary tumour affects women five times more frequently than men and most commonly occurs between 25-40 years of age.
The most distinctive features of Cushing syndrome are the deposits of fat over the clavicles and back of the neck (buffalo hump), the rounded puffy face (moon face, tomato face) with the contrasting slender wasted limbs. Bones are weakened, and activities such as bending, lifting or rising from a chair may lead to backaches, rib and spinal fractures. Many people suffer severe fatigue, weak muscles, high blood pressure, high blood sugar, irritability, anxiety and depression.
Signs and symptoms appearing in the skin include:
Although the diagnosis of Cushing syndrome may be made clinically, it is important to confirm it and explain the reasons for it. Laboratory tests may include:
Imaging to locate a tumour may include CT scan, MRI or ultrasound.
Treatment depends on the cause of the glucocorticoid excess and may include surgery, radiation, chemotherapy or drug therapy.
|Exogenous steroid administration||
|Ectopic ACTH syndrome||
Drugs that inhibit glucocorticoid hormones (e.g. mitotane) may sometimes be used in conjunction with the above therapies.
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