Cushing's Syndrome

Cushing's syndrome, is also called hypercortisolism, it is a rare endocrine disorder (Read about "Endocrine System") characterized by a variety of symptoms and physical abnormalities. The National Institute of Neurological Disorders and Stroke (NINDS) says 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. (The adrenal glands are located on the top of the kidneys.) It can also be produced synthetically. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says Cushing's syndrome is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year.

Common features of Cushing's syndrome, according to NINDS include:

• upper body obesity (Read about "Obesity")
• severe fatigue and muscle weakness
• high blood pressure (Read about "Hypertension: High Blood Pressure")
• backache
• elevated blood sugar
• easy bruising
• 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. (Read about "Menstrual Disorders")

Causes

Cushing's syndrome occurs when the body's tissues are exposed to excessive levels of cortisol for long periods of time. NIDDK says many people suffer the symptoms of Cushing's syndrome because they take glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation. (Read about "Asthma" "Rheumatoid Arthritis" "Lupus" "Transplants") The National Adrenal Disease Foundation (NADF) says this is called iatrogenic Cushing's syndrome.

Others develop Cushing's syndrome because of overproduction of cortisol by the body. That can result from a number of things, according to NINDS including:

• pituitary adenomas (benign tumors of the pituitary glands) which secrete increased amounts of adrenocorticotropic hormone (ACTH). This is called Cushing's disease.
• 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)
• adrenal tumors (tumors of the adrenal glands) In this case NADF says the tumor is the producer of the excess cortisol.

NADF says the most common cause of Cushing's syndrome is the taking of medication, followed by ectopic ACTH syndrome, pituitary adenomas and the fewest cases are caused by adrenal tumors. NADF says a major source of ectopic ACTH is lung cancer tumors, but it often is not recognized. (Read about "Lung Cancer")

Treatment

Treatment of Cushing's syndrome depends on the cause of the overproduction of cortisol, according to NINDS. 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. NINDS says most cases of Cushing's can be cured.

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