Cushing's Syndrome
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
