Cushing's syndrome

21:55 - 4 May , 2021

Disease

What is Cushing's syndrome?

It is a disease caused by high levels of cortisol in the body for a long time, either by prolonged intake of oral corticosteroids or by the adrenal glands generating too much cortisol, which may be due to dysfunction or the presence of tumors. It can affect people of any age and sex, causing, in addition to the accumulation of fat in localized areas, high blood pressure, bone damage, and diabetes. There are two types of Cushing's syndrome: 
  • Exogenous: it is the most common and is caused by external factors, such as excessive intake of oral corticosteroids. 
  • Endogenous: caused by internal factors that cause excessive cortisol production.
Both types have the same symptoms, the difference lies in the cause of their appearance.

Symptoms

The signs and symptoms may vary depending on cortisol levels, but the most common are:
  • Acne.
  • Overweight and accumulation of fat on the chest, back, and face. 
  • Hair loss.
  • Healing problems.
  • Muscle weakness.
  • Depression and anxiety. 
  • Irritability.
  • Recurring infections.
  • Cognitive problems.
  • Headache.
  • Burgundy striated lines on the abdomen, legs, arms, and breasts.
  • Tiredness.
  • Swelling of the limbs.
  • Insomnia.
  • Thinness and skin fragility.
  • Bruising.
  • Excessive sweating.
Women may also have:
  • Menstrual abnormalities.
  • Hirsutism. 
In the case of men:
  • Erectile dysfunction.
  • Sterility.
  • Lack of sexual desire.
Potential risks:
  • Type 2 diabetes.
  • High blood pressure.
  • Recurring infections.
  • Lack of energy and decreased strength and muscle mass.
  • Osteoporosis.

Diagnosis and treatment

The studies that your doctor will request once you have performed a physical examination and analyzed your symptoms and clinical history, will mainly be blood, urine, and saliva tests to check cortisol levels. He or she may also order imaging studies such as MRI or CT scan to look for any abnormalities in the adrenal glands or pituitary gland. These types of diagnostic tests are of great help in ruling out other conditions whose symptoms are similar to Cushing's disease, such as polycystic ovary syndrome, eating or hormonal disorders. Treatment will depend on whether the problem originated in the adrenal glands, in the pituitary gland, or elsewhere. The traditional treatment is based, mainly, on reducing the consumption of corticosteroids and the supply of certain drugs. But if the cause is a tumor, it is likely that you will undergo surgery and apply doses of radiotherapy. After surgery, you'll need cortisol replacement medications to provide your body with the proper amount of cortisol. Over time, normal adrenal hormone production usually returns. However, there are people who require replacement therapy for life. In ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • mayoclinic.org
  • medlineplus.gov
  • msdmanuals.com
  • hormone.org
  • medigraphic.com
  • Montoya EJF, Builes MCE, Gutiérrez RJ, et al. Muestreo de senos petrosos inferiores en el diagnóstico de pacientes con síndrome de Cushing dependiente de hormona adrenocorticotrópica. Medicina & Laboratorio. 2013;19(09-10):411-450.
  • Morán-Villaseñor E, Palacios-López C, Sáez OM, et al. Síndrome de Cushing iatrogénico y sarna costrosa por uso de esteroides tópicos. Acta Pediatr Mex. 2018;39(2):172-178.
  • Ledón LL, Fabré RBL, García ÁCT, et al. Sexualidad de personas con acromegalia y síndrome de Cushing; experiencias y aspectos psicosociales relacionados. Rev Cuba Endoc. 2017;28(1):11-20.
  • Robles TE, Leal CL, Díaz SC. Tratamiento farmacológico del síndrome de Cushing. Rev Cuba Endoc. 2014;25(3):206-215.

						

Internal Medicine

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