Cushing's Syndrome

What is Cushing's Syndrome?

Cushing's Syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol, a hormone produced by the adrenal glands. This condition can result from the use of corticosteroid medication or from the body producing too much cortisol.

Causes and Risk Factors

• Prolonged use of corticosteroid medications: Such as prednisone for conditions like asthma or rheumatoid arthritis.
• Overproduction of cortisol: Due to adrenal gland tumors or pituitary gland tumors (Cushing's disease).
• Adrenal hyperplasia: Enlargement of the adrenal glands.

Symptoms of Cushing's Syndrome

Common symptoms include:

• Weight gain, particularly around the midsection and upper back
• Rounded face (moon face)
• High blood pressure
• Skin changes: Thinning skin, easy bruising, and purple stretch marks (striae) on the abdomen, thighs, or breasts
• Muscle weakness
• Excessive hair growth in women (hirsutism)

Diagnosis and Treatment

Diagnostic Tests

Diagnosis of Cushing's syndrome involves:

• 24-hour urinary free cortisol test: Measures cortisol levels in urine.
• Salivary cortisol test: A late-night saliva sample to check cortisol levels.
• Dexamethasone suppression test: Evaluates how cortisol levels change with a low dose of dexamethasone.
• Imaging tests: Such as CT or MRI scans to detect tumors on the adrenal or pituitary glands.

Treatment Options

• Reducing corticosteroid use: If the condition is due to corticosteroid medication.
• Surgery: To remove adrenal or pituitary tumors.
• Radiation therapy: For tumors that cannot be removed surgically.
• Medications: To control cortisol production.

Prognosis

With proper treatment, most people with Cushing's syndrome can recover fully, although long-term health monitoring is often necessary.