The Basics of Cushing’s Syndrome

In 1932, American neurosurgeon Harvey Cushing described the linked findings between a specific pituitary tumor and certain physical manifestations such as abnormal obesity of the face. This condition was later renamed as Cushing Disease.

Cushing’s syndrome as a terminology was used to refer to the cases wherein the same classic symptoms are exhibited regardless of the cause. It is a relatively rare disease but is four times more prevalent in females than in males and may occur during or right after pregnancy.[1]

This condition is also called Hypercortisolism due to the presence of too much cortisol in the body. Long-term exposure to synthetic cortisol or diseases affecting the adrenal gland can lead to the development of Cushing’s syndrome.[2]

Causes of Cushing’s Syndrome

Estimates range that about 40 to 70 out of a million people have Endogenous Cushing’s Syndrome (wherein the disease originates inside of the body rather than caused by outside influences such as medicine).[3]

One of the main causes of Endogenous Cushing’s syndrome is Adrenocorticotropic hormone (ACTH)-producing pituitary tumors. These tumors stimulate the adrenal glands to produce way more cortisol than needed leading to Cushing Disease. However, ACTH-producing tumors can also develop elsewhere, called ectopic tumors, still leading to an excess of cortisol hormones circulating in the body.[4]

Glucocorticoids (cortisol-like medication) which are used to treat asthma, lupus, and rheumatoid arthritis can also cause Cushing’s syndrome. More than ten million Americans take glucocorticoids every year, but no record shows how many of these patients have developed Cushing’s Syndrome.[5]

Symptoms of Cushing’s Syndrome

The manifestation of Cushing’s syndrome symptoms depends on the patient’s biological makeup. Some symptoms appear gradually and some are very sudden but any symptom can get worse if not treated at the right time.

One of the early signs of Cushing’s Syndrome is sudden weight gain characterized by increased fats on the chest and abdomen area, but evidently slimmer arms and legs, a “buffalo hump” (fat buildup on the nape and shoulders) and a puffed up, reddish face.

Other symptoms include easily bruised skin, large and purple-colored stretch marks, decreased libido, mood swings, and weakness in the arms and thighs. Blood pressure may also be affected by this condition if medical attention is not sought.[6]

Possible treatment of Cushing’s Syndrome

To address the over-exposure to cortisol, treatments must be tailor-fitted depending on the symptoms and exact cause of the Cushing’s syndrome. If the cause is glucocorticoids or other cortisol-like medications, then gradually decreasing the dosage is a must to help the body regain normal production of cortisol.

Surgery and radiation therapy may also be done if the syndrome is caused by tumors. Once the tumor is removed including affected tissues in the area, medication can also be prescribed to control further symptoms. A combination of treatments is advisable to ensure effectiveness.[7]

 

[1] Cushing Syndrome. Encyclopaedia Brittanica. https://www.britannica.com/science/Cushing-syndrome

[2] Cushing Syndrome. The Mayo Clinic. (2018 March 06). https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310

[3] Cushing’s Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. (2018 May). https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome

[4] Cushing’s Syndrome & Disease – Causes. The Pituitary Society. https://pituitarysociety.org/patient-education/pituitary-disorders/cushings/what-causes-cushings-disease-and-cushings-syndrome

[5] Cushing’s Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. (2018 May). https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome#causes

[6] Cushing’s Syndrome. National Health Service UK. (2018 January 18). https://www.nhs.uk/conditions/cushings-syndrome/

[7] Cushing’s Syndrome Treatments. Gentile J M. (2016 January 14). EndrocrineWeb. https://www.endocrineweb.com/conditions/cushings-syndrome/cushings-syndrome-treatments

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