Cushing’s syndrome is a rare endocrine illness caused by exposure of body tissues to too much cortisol in the bloodstream. Produced by the adrenal glands, cortisol is a substance (hormone) that helps the body control blood pressure and respond to stress. Extra cortisol, however, produces abnormal body changes.
Cushing’s syndrome affects both men and women of any age but occurs most often in women 25 to 45 years old. It may increase the risk of getting diabetes, hypertension, osteoporosis, and obesity.
Extra cortisol may come from medicines prescribed by doctors for other conditions (e.g., asthma, bronchitis, arthritis). Certain tumors may produce excess cortisol. These tumors may be in the pituitary gland, adrenal gland, or other places.
Symptoms are weight gain, rounded face, fat around the neck, and thin arms and legs. Children are obese and grow slowly. The stomach, legs, arms, and breasts may show purplish-pink stretch marks. Thin, delicate skin bruises easily and heals poorly. Bones are weak and brittle and may break. Hormonal changes in women mean that they usually have too much hair growth on the face, neck, chest, stomach, and thighs. Periods may be irregular or stop. Men may be impotent. Other symptoms are urinating often, severe tiredness, weak muscles, high blood pressure, personality changes, and feeling irritable, anxious, and depressed.
The health care provider will make a diagnosis by doing a physical examination and testing blood and urine.
If cortisol levels are high, another health care provider (an endocrinologist, a specialist who treats diseases of glands and hormones) will order other tests. These tests usually involve taking medicine and providing blood and urine samples. Computed tomography (CT) or magnetic resonance imaging (MRI) of the belly (abdomen) to look for tumors of adrenal glands (located above the kidneys) or of the brain to look for pituitary gland tumors may be done.
If medicine is the cause, the health care provider can change the dose to lower the cortisol levels or give medicine that blocks effects of cortisol on the body.
For an abnormal growth (tumor), treatment may include surgery to remove the growth, radiation, and drugs (chemotherapy).
If no cause is found, rarely adrenal glands are removed to prevent extra cortisol from being made. Medicine to replace missing cortisol is then needed.
Recovery time depends on duration of the illness, cortisol levels, and basic health.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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