Cushing's syndrome is a disease caused by increased production of cortisol, or by excessive use of cortisol or other steroid hormones.
Alternative Names: Hypercortisolism
Causes, incidence, and risk factors:
Cushing's syndrome is a condition that results from an excess of cortisol, a hormone produced by the adrenal glands. The most common cause of Cushing's syndrome is Cushing's disease, caused by excessive production of the hormone ACTH by the pituitary gland. ACTH stimulates the adrenal glands to produce cortisol.
Cushing's syndrome can be caused by a tumor of the pituitary gland, a tumor of the adrenal gland, a tumor somewhere other than the pituitary or adrenal glands (ectopic Cushing's syndrome), or by long-term use of corticosteroids (drugs commonly used to treat conditions such as rheumatoid arthritis and asthma).
Risk factors for Cushing's syndrome are adrenal or pituitary tumors, long-term therapy with corticosteroids, and being female.
Additional symptoms that may be associated with this disease:
Signs and tests:
Tests to confirm high cortisol level:
Tests to determine the cause:
Treatment depends upon the cause of the disorder. In Cushing's syndrome caused by drug therapy with corticosteroids, the drug dose must be slowly decreased under medical supervision.
In Cushing's disease caused by a pituitary tumor, surgery to remove the tumor is recommended. Radiation is sometimes needed as well. Hydrocortisone (cortisol) replacement therapy is needed after surgery. In some cases, life-long cortisol-replacement therapy becomes necessary.
Cushing's syndrome caused by an adrenal tumor is usually treated by surgical removal of the tumor. If the tumor cannot be removed, certain medications can suppress the secretion of cortisol.
In Cushing's syndrome caused by a tumor secreting ACTH, removal of the tumor is the best way to treat the Cushing's syndrome. Cortisol replacement therapy is needed after surgery until cortisol production resumes. In some cases, life-long therapy with cortisone drugs becomes necessary.
Tumor removal may lead to full recovery, but there is a chance of recurrence. Survival for people with ectopic tumors depends upon the overall outcome associated with the particular tumor type. Untreated, Cushing's syndrome can lead to death.
Calling your health care provider:
Call your health care provider if symptoms develop that indicate Cushing's syndrome.
Cushing's syndrome may be prevented by an awareness of the associated symptoms so that early detection can be made.