Cushing Syndrome
What is Cushing’s syndrome? All the information about its causes, symptoms, and treatments.
Symptoms and Causes
Cushing’s syndrome is caused by an excess of cortisol in the body over a prolonged period, regardless of whether it is due to the body producing it in large amounts or the effect of certain medications.
The cortisol hormone, secreted by the adrenal glands, is responsible for regulating food metabolism, the body’s immune function, and the response to stressful situations. When the normal production curve is altered, the body does not respond properly. As a result, Cushing’s syndrome can lead to type 2 diabetes, fat accumulation between the shoulders, bone loss, or increased blood pressure.
In most cases, treatments reverse the symptoms, and affected individuals can lead a normal life. Early diagnosis is crucial for a full recovery.
Symptoms
The most characteristic symptoms of Cushing’s syndrome are:
- Round, moon-shaped face.
- Central body obesity, especially in the abdomen.
- Muscle atrophy in the arms and legs.
- Buffalo hump: fat accumulation between the shoulders.
- High blood pressure.
- Pink stretch marks on the thighs, hips, abdomen, or breasts.
- Easy bruising.
- Slow healing.
This disease may also cause insomnia, headaches, osteoporosis, anxiety, or irritability. Additionally, women may experience hirsutism and irregular menstrual periods, while men may experience reduced libido.
Causes
The primary cause of Cushing’s syndrome is an excess of cortisol in the body for a prolonged period. The disease is classified into two different types depending on the reasons for its occurrence:
- Exogenous Cushing Syndrome: This is the most common type. It is caused by the use of medications that act in the body like cortisol and disappears when these medications are discontinued.
- Endogenous Cushing Syndrome: This is due to the body producing excess cortisol. It is usually the result of a benign tumor in the adrenal glands or pituitary gland.
Risk Factors
The risk of developing Cushing’s syndrome increases when taking corticosteroid medications and when being a woman, as the disease is more common in women.
Complications
When Cushing’s syndrome is not properly treated, it can lead to complications such as serious infections, type 2 diabetes, bone loss, or muscle weakness.
Prevention
Cushing’s syndrome can only be prevented when it is of the exogenous type. The best way to prevent it is by limiting the use of corticosteroid medications and following the doctor's instructions when they need to be taken.
Which doctor treats Cushing’s Syndrome?
Endocrinologists diagnose Cushing’s syndrome. In some treatments, radiation therapy specialists may be involved.
Diagnosis
Diagnosing Cushing’s syndrome is not always straightforward, as it can be confused with many other diseases. The following tests are usually conducted to make a diagnosis:
- Medical history and review of the patient's medical records.
- Physical exam looking for some of the visible symptoms of the condition.
- Blood and urine tests to check cortisol levels and other hormones.
- Imaging tests to observe the condition of the pituitary and adrenal glands.
Treatment
Treatment for Cushing’s syndrome varies depending on the causes and characteristics of each patient. When it is of the exogenous type, the medication causing it should be gradually withdrawn, and alternative medications should be found to treat the underlying condition. In cases of endogenous Cushing syndrome, the following options may be used:
- Surgery to remove the adrenal tumor via laparoscopy, which requires minimal incisions and facilitates recovery.
- Surgery to remove the pituitary tumor by introducing a catheter through the nasal passage.
- Radiation therapy sessions to reduce the tumor if it cannot be surgically removed.
- Medications to control cortisol levels.
