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Cushing's Syndrome

Clinical Information

A hormonal disorder caused by prolonged exposure to the hormone cortisol, Cushing’s syndrome is usually more common in women. The condition is called Cushing’s disease when it is caused by a tumor of the pituitary gland, which causes the body to produce excess cortisol.

Causes

Prolonged or excess exposure to cortisol can also result from:

  • Long-term use of corticosteroid hormones such as cortisone or prednisone
  • A tumor or abnormality of the adrenal gland, which causes the body to produce excess cortisol
  • Tumors of the lungs, thyroid, pancreas or thymus gland, which can, in rare instances, produce hormones that trigger the syndrome

Symptoms

Symptoms may vary, but commonly include:

  • Weight gain of the upper body and trunk
  • Skin changes including darkening of the skin, easy bruising and purple stretch marks
  • Excess hair growth or acne in women
  • Menstrual disorders, especially infrequent or absent periods
  • Fatigue and muscle weakness
  • Personality changes or mood swings

Diagnosis

Tests may include:

  • Collection of urine over a 24-hour period to test for cortisol levels
  • A dexamethasone suppression test in which a synthetic cortisol is taken overnight or over the course of several days and blood or urine cortisol levels are measured at specific intervals
  • X-rays, scans and other tests to determine whether there is a tumor in the pituitary or adrenal glands or another area of the body

Treatment

Treatment can involve the gradual withdrawal of cortisone-type drugs and drug treatment to suppress adrenal gland function. In many Cushing’s cases, tumors that require surgery can be removed with minimally-invasive techniques such as laparoscopic adrenalectomy.

Cushing’s Syndrome Algorithm
Cushing's Syndrome Algorithm

Procedures


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