Cushings disease (excessive cortisol)

Pelvis | Urology | Cushings disease (excessive cortisol) (Disease)


Cushing disease is a metabolic disorder that is characterized by abnormally increased secretion of adrenocortical steroids, in particular cortisol, caused by increased amounts of adrenocorticotropic hormone secreted by the pituitary gland. Excess adrenocortical hormones result in accumulations of fat on the abdomen, chest, upper back and face and occurrence of edema, hyperglycemia, increased gluconeogenesis, muscle weakness, purplish striae on the skin, decreased immunity to infection, osteoporosis with susceptibility to bone fractures, acne and facila hair growth in women.

Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity). A common sign is the growth of fat pads along the collar bone and on the back of the neck (buffalo hump) and a round face often referred to as a moon face. Other symptoms include hyperhidrosis (excess sweating), telangiectasia (dilation of capillaries), thinning of the skin (which causes easy bruising and dryness, particularly the hands) and other mucous membranes, purple or red striae (the weight gain in Cushings syndrome stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders), and hirsutism (facial male-pattern hair growth), baldness and/or cause hair to become extremely dry and brittle.

Causes and Risk factors

Pituitary tumor is the most common cause for Cushings disease. The pituitary tumor stimulates the adrenal glands to produce too much cortisol. Less common causes for Cushings disease include small cell carcinoma of the lung and bronchial carcinoid tumor.

Diagnosis and Treatment

Treatment depends on the cause and may include:

(1) Tumour of the pituitary gland - the tumour is surgically removed. Other options include radiation therapy and drug therapy to shrink the tumour and stop it from producing hormones. Hormone therapy for up to two years after surgery may also be required.

(2) Tumour of the adrenal gland - the tumour is surgically removed. Replacement hormone therapy may be necessary in the short term. ...

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