Cushing's syndrome (hypercortisolism), happens when tissues are exposed to an
overabundance of the hormone called cortisol. When an inappropriate amount
of cortisol is released by the adrenal glands, it can alter the normal functions
of blood pressure, energy production, the ability to fight disease and how the
body maintains and handles stress. This results in the symptoms of
Cushing's syndrome.
Symptoms
Many teenagers and young children with Cushing's syndrome often show many of
the following symptoms:
Adults who suffer from Cushing's syndrome may also have some of the same
symptoms. In addition, they may also have such symptoms as:
Causes
Cushing's syndrome occurs when:
- a non-cancerous tumor in the pituitary gland produces increased amounts of
the adrenocorticotropin hormone (ACTH). This, in turn, prompts the
adrenal glands to over-produce cortisol. This form of Cushing's syndrome
is better known as Cushing's disease.
- growth on the adrenal glands whether cancerous or not, can cause the
adrenal glands to release extra cortisol.
- certain types of cancerous tumors found in other parts of the body can
produce adrenocorticotropin This causes the adrenal glands to produce an
abundance of cortisol.
- a person taking certain hormones for an extended amount of time as
treatment for another disease or disorder, for example, a person taking a
steroidal anti-inflammatory medication for arthritis.
Diagnosis
The patient's physician will review their medical records and perform a
physical exam. If enough evidence suggests the patient may have Cushing's
syndrome, the physician will have more tests performed on the patient. The
process of getting a definite diagnosis will involve:
- seeing if there is an abundance of cortisol in the body and discovering
the cause of the extra cortisol.
- a urine test to measure how much cortisol is being produced.
If the cortisol level indicates Cushing's syndrome, the physician may order
other tests to discover the cause. These tests may include:
The physician will also order a series of biochemistry tests. The
dexamethasone suppression test involves taking man-made cortisol orally for
several days. While the patient is taking this test, the cortisol levels
in the blood and urine are measured on a daily basis. Another test called
the corticotropin-releasing hormone (CRH) simulation test involves the patient
getting an injection of CRH followed by a blood test to see if there is a rise
in the cortisol and ACTH levels.
Samples of the blood are gathered through a catheterization procedure and are
tested to see if the pituitary gland is what is causing the high level of ACTH.
Treatments
If it is discovered that Cushing's syndrome is the result of taking hormones
as treatment for another disease, the physician will adjust the hormone dosage.
If Cushing's syndrome is being caused by the body producing an abundance of
cortisol, the physician will use such treatments as:
In many cases, Cushing's syndrome can be cured. But, as with any
disease, there is no guarantee. The effectiveness of the treatment depends
on what is causing it and the severity of the disease. Even if a cure is
not possible, most patients will eventually achieve some level of recovery.
My aunt was diagnosed with Cushing's syndrome four years ago. Her
doctor discovered it early enough, and through treatment and medication the doctor
expects a full recovery as long as she continues to keep taking the medication.
She is living a normal life and there have not been any relapses and no symptoms
of the disease. She is thankful that the doctor prescribed the treatments
that he did and is expected to live a long happy life.
Sources:
National Institute of Child Health and Human Development
National Institutes of Health