Cushing's Syndrome - Definition, Causes, Symptoms and Treatment

Cushing's syndrome is a rare endocrine disorder caused by high levels of cortisol in the blood. Sometimes called "hypercortisolism. It is relatively rare and most commonly affects person aged 20 to 50. An estimated 10 to15 of every million people are affected each year. Cushing's syndrome occurs when the body's tissues are exposed to excessive levels of cortisol for long periods of time. 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. Cushing's syndrome is also a relatively common condition in domestic dogs in which causes are the same as the syndrome in humans, and in horses, (where it is almost invariably caused by pituitary neoplasia) characterised by a long, tightly curled coat which does not shed and abnormal fat deposition. The syndrome in horses leads to weight loss, polyuria and polydipsia and may cause laminitis.

Cushing's disease is the name given to a type of Cushing's Syndrome caused by too much ACTH production in the pituitary. The most common cause of Cushing's syndrome is the use of oral corticosteroid medication. Common symptoms 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. Risk factors for Cushing syndrome are adrenal or pituitary tumors, long-term therapy with corticosteroids, and being female. Many people suffer the symptoms of Cushing's syndrome because they take glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus or other inflammatory diseases. Cortisol performs vital tasks in the body. It helps maintain blood pressure and cardiovascular function, reduces the immune system's inflammatory response, balances the effects of insulin in breaking down sugar for energy, and regulates the metabolism of proteins, carbohydrates, and fats.

Common findings on routine laboratory tests in people with Cushing's Syndrome include a higher white blood count, a high blood sugar (often into the diabetic range), and a low serum potassium. One of cortisol's most important jobs is to help the body respond to stress. Some rare tumours in other parts of the body sometimes make ACTH. For example, some types of lung cancer. The 'ectopic' ACTH then stimulates the adrenals to make too much cortisol. People suffering from depression, alcoholism, malnutrition and panic disorders also have increased cortisol levels. Treatments for Cushing's syndrome are designed to lower the high level of cortisol in your body. Cushing's syndrome is treated by restoring a normal balance of hormones. Cushing syndrome caused by an adrenal tumor is usually treated by surgical removal of the tumor.Hormone supplements are usually given before surgery and must be taken for weeks and sometimes months after surgery, until the second gland recovers normal function. Medications to control excessive production of cortisol include ketoconazole (Nizoral), mitotane (Lysodren) and metyrapone (Metopirone). Medical therapy is also sometimes used before surgery for people who are very sick.

Treatment for Cushing's disease Tips

1. Cushing's syndrome is treated by restoring a normal balance of hormones.

2. Cushing syndrome is usually treated by surgical removal of the tumor.

3. Hormone supplements are usually given before surgery and must be taken for weeks and sometimes months after surgery, until the second gland recovers normal function.

4. Medications to control excessive production of cortisol include ketoconazole (Nizoral), mitotane (Lysodren) and metyrapone (Metopirone).

5. Radiation therapy-Radiation can be given in small doses over a six-week period, or by a technique called stereotactic radiosurgery or gamma-knife radiation.

6. Chemotherapy - radiation treatments of the pituitary gland (to weaken it and lower its output of ACTH) - or removal of any benign growths of the pituitary gland.

7. Adrenal adenomas are always treated by surgically removing the tumor with either an abdominal or side (flank) incision.