Cushing's syndrome

The Cushing's syndrome - A hormonal disorder caused by an abnormally high level of corticosteroid hormones in the blood. Cushing’s syndrome is characterized by a reddened, moon-shaped face, wasting of the limbs, thickening of the trunk, and a humped upper back.

Other symptoms include acne; stretch marks on the skin; bruising; osteoporosis (loss of bone density); susceptibility to infection and peptic ulcers; and, in women, increased hairiness. Mental changes frequently also occur, causing depression, insomnia, paranoia, or, euphoria. Oedema, hypertension, and diabetes mellitus may develop. In children, growth may be suppressed.

The excess of hormones is most commonly due to prolonged treatment with corticosteroid drugs. Such cases of Cushing’s syndrome are usually mild. In other cases, high hormone levels are due to overactivity of the adrenal glands because of an adrenal tumour, or due to a pituitary tumour affecting production of ACTH (adrenocortocotrophic hormone), which in turn stimulates the adrenal glands.

Cushing’s syndrome due to corticosteroid drugs usually disappears when the dose of the drug is gradually reduced. In cases of Cushing’s syndrome that are caused by an adrenal gland tumour, the tumour will be removed surgically. If the cause of the disease is a pituitary tumour, it may be removed surgically or shrunk by irradiation and drug treatment. In both of these cases, surgery is followed by hormone replacement therapy.