Cushing's syndrome (SC), or hypercortisolism, is a symptom complex associated with hormonal disorders in which the adrenal cortex produces an excessive amount of cortisol. What are the causes and symptoms of Cushing's syndrome? What is the treatment of people struggling with hypercortisolism?

Contents:

  1. Cushing's syndrome - causes
  2. Cushing's syndrome - symptoms
  3. Cushing's syndrome - diagnosis
  4. Cushing's syndrome - which doctor?
  5. Cushing's syndrome - treatment

Cushing's syndrome , otherwisehypercortisolismorprimary hyperadrenocorticism , is a disease in the course of which the adrenal cortex secretes steroid hormones, i.e. glucocorticosteroids, in excessive amounts. The consequence is complex symptoms related to many systems in the body. Cushing's syndrome is most commonly diagnosed in people between the ages of 20 and 50.

Cushing's syndrome - causes

There are two forms of Cushing's syndrome: ACTH dependent and ACTH independent. In the first case, Cushing's disease is caused by Cushing's disease. The essence of this disease is the increased secretion of the pituitary hormone - corticotropin (ACTH), which in turn stimulates the adrenal cortex to secrete cortisol. The development of Cushing's syndrome may be influenced by the syndrome of ectopic ACTH secretion from a tumor located outside the pituitary gland (e.g. carcinoid, thymoma, pancreatic and thyroid tumor).

In an ACTH-independent form, the presence of an adrenal tumor, pituitary adenoma or adrenal hyperplasia may be the cause of excess cortisol in the body.

Another cause of Cushing's syndrome may be the use of glucocorticoid drugs such as prednisone and prednisolone. These drugs are used in the treatment of, inter alia, asthma and rheumatoid arthritis.

Cushing's syndrome - symptoms

Characteristicsymptoms of Cushing's syndromeis cushingoid obesity: obesity of the upper body (arms and legs are lean), accumulation of fat between the arms (the so-called buffalo neck ), round, full face, the so-called moon face.

In addition, the following is observed in the course of the disease:

1. Skin changes

  • facial redness
  • acne
  • skin infections
  • stretch marks on the skin of the abdomen, thighs andbreasts
  • thin skin that is prone to bruising

2. Skeletal and muscle ailments

  • bone pain or tenderness
  • back pain that occurs during everyday activities
  • ribs and spine fractures (caused by thinning bones)
  • weak muscles

3. Mental changes

  • depression
  • anxiety
  • changes in behavior
  • fatigue

Women with Cushing's syndrome often struggle with excessive hair on their face, neck, and chest, as well as abdomen and thighs. Their menstrual cycle becomes irregular or stops.

On the other hand, men with Cushing's syndrome may experience less sex drive than normal and even struggle with impotence.

Cushing's syndrome - diagnosis. How do you recognize Cushing's syndrome?

The initial diagnosis can be made based on the medical history (then the doctor usually asks the patient if they are taking glucocorticoids) and physical examinations.

Then laboratory tests and hormone tests are performed:

  • excretion of free cortisol in urine
  • low dose dexamethasone inhibition test
  • late evening cortisol concentration in saliva
  • cortisol circadian rhythm - midnight cortisol concentration
  • dexamethasone 2 mg inhibition test
  • ACTH concentration measurement
  • CRH stimulation test

Final diagnosis is made after imaging tests (computed tomography and magnetic resonance imaging to assess the pituitary and adrenal glands).

Cushing's syndrome - which doctor will diagnose the disease?

If Cushing's syndrome is suspected, see an endocrinologist.

Cushing's syndrome - treatment

Treatment for Cushing's syndrome depends on its cause. If the disease is caused by the use of corticosteroids, the doses of the drug should be gradually reduced under the supervision of a physician. If drug therapy cannot be discontinued, the physician should monitor the patient's he alth on an ongoing basis.

If Cushing's syndrome is the result of an excessive release of the hormone ACTH (Cushing's disease), both adrenal glands are usually removed. After surgery, you may need replacement therapy that should be continued throughout your life.

If the tumor cannot be removed, medications to help block the release of cortisol are usually used.

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