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Cushing Syndrome

Medical Questions » Cushing Syndrome
Name: Cushing Syndrome
Also known as: Adrenocortical Hyperfunction; Hyperadrenocorticism
Syndrome resulting from excessive amounts of steroids in the blood.
Causes of Cushing Syndrome
The hypothalamus is the part of the brain that decides how much natural steroid is required. It sends nerve messages to the pituitary gland, which sits under the center of the brain and it sends a chemical message to the adrenal glands that sit on top of each kidney. These produce the steroids required by the body. Tumors or overactivity (may be triggered by pregnancy or stress) in the hypothalamus, pituitary gland or adrenal gland can result in the overproduction of steroids. May also be due to taking excessive amounts of steroids (eg. prednisone) for medical reasons.
Symptoms of Cushing Syndrome
Fat face, fatty deposits on the upper back (called a buffalo hump), obesity of the abdomen and chest with thin arms and legs, high blood pressure, impotence, cessation of menstrual periods, skin infections and pimples, headaches, backache, excess hair growth on the face and body, mood changes, excessive bruising, thinning of the bones (osteoporosis — which can cause bones to fracture easily), stretch marks on the breasts and abdomen, kidney stones, and generalized weakness.
Tests for Cushing Syndrome
Complex blood tests can confirm the diagnosis, but finding the cause can be very difficult, and CT scans and magnetic resonance imaging (MRI) may be used to find very small tumors.
Treatment for Cushing Syndrome
If a tumor can be found in the adrenal or pituitary gland, it is surgically removed. Other treatments include irradiation of the pituitary gland, or removal of both adrenal glands. Drug treatment is generally unsuccessful, but if both adrenal glands are removed it is necessary to supply steroids and other hormones by taking tablets or having injections regularly. If due to taking steroid medication, the dosage of this should be reduced if possible.
Complications of Cushing Syndrome of its treatment
Strokes, heart attacks, broken bones, diabetes, increased susceptibility to infections (particularly of the skin and urine), and psychiatric diseases. Nelson syndrome (see separate entry) is a complication of treatment.
Likely Outcome of Cushing Syndrome
Depends on its cause. Some tumors of the adrenal or pituitary glands are very aggressive and spread to other areas to continue the syndrome, and these patients have a poor life expectancy. In others, a lifelong cure may be obtained by removing a localized tumor. If caused by excessive steroid medication, the syndrome is cured by stopping the medication, but the patient may require the steroids for control of asthma, rheumatoid arthritis or other diseases, and they must tread a very narrow path between the side effects of the medication and the necessary treatment of a disease.
       
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