Endocrine Diseases

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Cushing Syndrome

Overview:

It is uncommon hormonal disorder caused by a high level of cortisol in the blood for a long time.
It occurs in children and adults of all ages.
The most important risk factors include tumors or the use of corticosteroid drugs for a long time.
Symptoms vary according to the high levels of cortisol in the body.
Raising the awreness about the disease is the key for diagnosing and treating it at early stages.

Definition:

It is an uncommon hormonal disorder caused by a high level of cortisol in the blood for a long time, and occurs in all ages.

Other Names:

Cushing's syndrome, hypercortisolism, moon face.

Causes:

Excess levels of the hormone cortisol are responsible for Cushing syndrome. Cortisol, which is produced in the adrenal glands, plays a variety of roles in your body. For example, cortisol helps regulate your blood pressure and keeps your cardiovascular system functioning normally. Cortisol also helps your body respond to stress and regulates the way you convert (metabolize) proteins, carbohydrates and fats in your diet into usable energy. However, the increase in the hormone cortisol is due to several reasons, including:

Pituitary gland and adrenal gland tumor (may be benign tumors).
The use of corticosteroid drugs for a long time; for the treatment of inflammatory diseases such as lupus and rheumatoid arthritis.

Risk Factors:

Sex: It is more common in women, especially those between the ages of 20 and 50 years.
Obesity.
Having type 2 diabetes and hypertension.

Symptoms:

The signs and symptoms of Cushing syndrome can vary depending on the levels of excess cortisol, including:

Weight gain, particularly around the waist and upper back, in the face, and between the shoulders.
Pink or purple stretch marks on the skin of the abdomen, thighs, breasts and arms.
Thinning, fragile skin that bruises easily.
Acne.
Severe fatigue and muscle weakness.
Slow healing of wounds.
Hypertension.
Depression and anxiety.
Cognitive difficulties.
Osteoporosis.
In children, impaired growth.

Women with Cushing syndrome may experience:

Thicker or more visible body and facial hair (hirsutism).
Irregular or absent menstrual periods.

Men with Cushing syndrome may experience:

Decreased libido.
Decreased fertility.
Erectile dysfunction.

When to See a Doctor?

Contact your doctor if you have symptoms that suggest Cushing syndrome, especially if you are taking corticosteroid medication to treat inflammatory diseases.

Complications:

Osteoporosis.
Hypertension.
Type 2 diabetes.
Frequent infections.
Loss of muscle mass.

Diagnosis:

Physical examination.
Lab tests: Urine, blood and saliva tests.
Other tests: CT scan, MRI, or pituitary gland test.

Treatment:

The treatment depends on the cause of the syndrome. Treatment options include:

Reducing corticosteroid use, if the cause of Cushing syndrome is long-term use of corticosteroid medications.

Surgery, if the cause of Cushing syndrome is a tumor.

Radiation therapy, for patients who are not suitable for surgery.

Medications, to control cortisol production in the body.

Prevention:

There are no specific ways of preventing the syndrome but raising awareness about the associated symptoms is the key to the diagnosis and treatment of the syndrome in its early stages.

Guidelines for Patients with Cushing's syndrome:

Maintaining your health by adopting a healthy diet.
Exercising to strengthen the bones, while avoiding the sports that cause bone fractures.
Quitting smoking and drinking alcohol.
Taking medications regularly as prescribed by your doctor.
Consulting your doctor when symptoms aggravate.