CUSHING'S SYNDROME
Description
Cushing’s syndrome, also called hypercortisolism, is a rare endocrine
disorder characterized by a variety of symptoms and physical abnormalities. It
may be caused by either prolonged exposure of the body’s tissues to high
levels of the hormone cortisol or by the overproduction of cortisol in the
body.
Cortisol is a natural substance produced by the adrenal gland. It can also
be produced synthetically. Common features of Cushing’s syndrome include
upper body obesity, severe fatigue and muscle weakness, high blood pressure,
backache, elevated blood sugar, easy bruising, and bluish-red stretch marks on
the skin.
In women, there may be increased growth of facial and body hair, and
menstrual periods may become irregular or stop completely. Exposure to too much
cortisol can occur for different reasons such as long-term use of
glucocorticoid hormones to treat inflammatory illnesses; pituitary adenomas
(benign tumors of the pituitary glands) which secrete increased amounts of
adrenocorticotropic hormone (ACTH); ectopic ACTH syndrome (a condition in which
ACTH is produced by various types of potentially malignant tumors that occur in
different parts of the body); and adrenal tumors (tumors of the adrenal
glands).
Treatment
Treatment of Cushing’s syndrome depends on the cause of the
overproduction of cortisol. If the cause is long-term use of a medication being
used to treat another disorder, the physician may reduce the dosage until
symptoms are under control.
Surgery or radiotherapy may be used to treat pituitary adenomas. Surgery,
radiotherapy, chemotherapy, immunotherapy, or a combination of these may be
used to treat ectopic ACTH syndrome. The aim of treatment is to cure the
hypercortisolism and to eliminate any tumor that threatens the
individual’s health, while minimizing the chance of endocrine deficiency
or long-term dependence on medications.
Prognosis
The prognosis for individuals with Cushing’s syndrome varies depending
on the cause of overproduction of cortisol. With treatment, most individuals
with Cushing’s syndrome show significant improvement, while improvement
for others may be complicated by various aspects of the causative illness. Some
kinds of tumors may recur. Most cases of Cushing’s can be cured.
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