Cushing's syndrome is a condition that occurs as a result of excessive levels of cortisol (a steroid hormone) in the body. It is very uncommon and usually occurs as a result of taking steroid medicine such as tablets, syrups and injections over a long period of time. These medicines usually contain an artificial form of cortisol.
There are two types of glucocorticoid action hormones. One, which is naturally found in our body and is called cortisol, is secreted by both adrenals. The other is a synthetic hormone also called "synthetic corticosteroids" which is prescribed in the form of drugs for its anti-inflammatory effect. Endogenous Cushing's syndrome occurs when cortisol is secreted excessively by the adrenals and Cushing's syndrome is exogenous or iatrogenic when it occurs after taking medication containing corticosteroids.
Whilst extremely rare, Cushing's syndrome usually occurs between the ages of 20 and 40 and affects women more often than men.
Cushing's syndrome has a combination of symptoms that can gradually develop and worsen over months and years. The most evident signs of Cushing's syndrome are:
- Weight gain in the face and upper body
- A puffy and red face
- Excess hairiness in women
- Fragile skin (leading to bruises and stretch marks)
- irregular menstrual cycles
Cushing's syndrome can be caused by drugs (synthetic corticosteroids) or by a tumour. This may be a tumour in the adrenal gland that makes too much cortisol or a tumour in the pituitary gland. Some tumours of the pituitary gland cause overproduction of another hormone, ACTH or adrenocorticotropic hormone, and cause the adrenal glands to produce too much cortisol.
DIAGNOSIS AND TREATMENT
A patient is most likely to be diagnosed with Cushing's syndrome if they're showing typical symptoms associated with the disease and are taking steroid medicine. The condition can be more complicated to diagnose if a patient is not using steroid medicine, which can mean that symptoms simply may resemble those of Cushing's syndrome.
If a doctor suspects Cushing's syndrome in a patient, they may take a sample of:
If any of the above demonstrate high levels of cortisol, the patient may then be referred to an endocrinologist (a specialist in hormone-linked conditions)
Cushing's syndrome is treated in the majority of cases by surgery. This involves removing the tumour to reduce the overproduction of cortisol. Radiation and chemotherapy can also be used for tumours in some cases.