What is Cushing's syndrome?

Cushing's syndrome is the clinical picture resulting from an overproduction of the hormone cortisol by the adrenal gland, the endocrine gland located on the upper pole of the kidney. This is a very serious disease and predominantly affects women between 20 and 40 years of age.

What are the causes of Cushing's syndrome?

Very often the syndrome is supported by an excess of production, by a benign pituitary tumor, the hormone ACTH, which normally regulates the endocrine function of the adrenal gland, but there are also other pathological conditions that can determine the presence of high levels of cortisol in the patient’s blood.
Some of the causes of Cushing’s syndrome are:

Proliferation of adrenal tissue

A by excess production of ACTH

1. Alterations of hypothalamic-pituitary function

2. ACTH secreting pituitary tumor

An excess production of ACTH or CRH from an endocrine tumor (e.g. Lung cancer)

Adrenal tumors

In adenoma (benign)

Carcinoma (malignant)

Side effects of medical treatment:

Prolonged treatment with high doses of steroids as anti-inflammatory

Long term treatment with ACTH

Corticosteroid therapy is often used to treat the chronic inflammatory processes.
The use of steroids is often essential, for example, in treating asthma and ulcerative colitis. Patients treated with high doses of steroids may develop the clinical picture of Cushing's syndrome and present a typical appearance. Until Cushing’s disease symptoms resolve completely disappear with dose reduction and interruption of treatment.

Alcoholics develop a condition called pseudo –Cushing: the characteristic redness of the face.

What are the Cushing's disease symptoms?

Cushing's syndrome is manifested in a characteristic way, with:

· Façades full moon

· Facial Redness

Obesity · localized mainly in the abdomen and face

· Stacking of fat on the upper back

Slimming · progressive limb

· Reddish in the abdomen

· Low muscle mass and strength loss

· Headache

· Backache

· Acne, seborrhea

· Increased thirst and urination

· Impotence

· Menstrual disorders

· Osteoporosis

· Hypertension

· Growth disorders in children

· Increase of unwanted hair on face and body in women

In addition to the signs and symptoms, patients with Cushing's syndrome can often make changes in mood, with a tendency to depression, to real events psychotic.

How does the doctor make the diagnosis?

The diagnosis of a full-blown framework is fairly straightforward. Not so easy is the early recognition of patients with Cushing's syndrome.

The suspect is generally asked by the family doctor based on a thorough medical examination. Subsequently, the patient is directed to a specialist endocrinologist.

The diagnosis is confirmed by the presence of high levels of cortisol in the blood and urine analysis after a specific suppression test (inhibition test with dexamethasone).

Further investigations are also necessary hormonal and instrumental to define the cause that led to the emergence of the syndrome.

Possible complications:

· Diabetes

· Hypertension

· Easy to infection

· Phenomena of bone fractures for osteoporosis

· Disorders related to the expansion of a possible pituitary tumor

What is Cushing's syndrome? The state in which the body produces too much cortisol is called Cushing's syndrome. Cortisol is also sometimes known as a hormone whose production increases in times of stress and is a natural steroid hormone that is like the "cortisone" in some medicines. Cushing's syndrome can be caused because the body produces too much cortisol or for taking too many drugs on the type of cortisone.

What causes Cushing's syndrome? The most common cause of Cushing's syndrome is the type of drugs taking cortisone orally (by mouth) every day for months or weeks. Prednisone is the most common medicine that is taken in this way.

Steroid medicines for asthma and inhaled steroid creams for eczema and other skin conditions do not cause Cushing's syndrome. Even oral medicines taken daily for short periods of time or every other day for longer periods do not often cause Cushing's syndrome.

The second most common cause of Cushing's syndrome is Cushing's disease. Tumors in the adrenal glands or elsewhere in the body can also cause Cushing's syndrome.

What is Cushing's disease? Cushing's disease is the name doctors use when Cushing's syndrome is caused by a pituitary gland tumor. The pituitary gland is located at the bottom of the brain that controls the body's production of cortisol. These small tumors can cause the adrenal glands, located near the kidneys, produce too much cortisol.

Tumors in the pituitary gland in Cushing's disease are usually not cancerous. However, if the tumors grow too much they can cause problems with your vision. What are the Cushing’s disease symptoms and the Cushing’s syndrome signs?

Cushing’s disease symptoms can form fatty deposits around your stomach and your upper back, but arms and legs stay thin and do not usually get fatter. Your skin gets thinner and is easily bruised. Cuts, scrapes and insect bites are slow to heal. You can form streaks of pink or purple skin. The face may become round and bloated. You may feel tired and have muscle weakness. You may feel depressed

Women usually have irregular menstrual periods and they may grow thick or body hair that is more visible than usual. High blood pressure, osteoporosis (weak and brittle bones) and the levels of blood sugar above normal may be signs of syndrome or Cushing's disease. Often you are given skin infections or other infections, and they take longer to heal.

How does my doctor know if I have Cushing syndrome or disease? Your doctor may start by asking some questions and a physical examination. If the cause is a medicine you are taking, no tests are needed. If your doctor thinks you have Cushing syndrome or disease, but does not include drugs that are causing this, you may need to have some blood tests and urine tests.

You may be asked to collect your urine for 24 hours. Your doctor will explain how to do this test. You may also be given a medicine called dexamethasone before collecting the blood or urine. This tests your response to steroids. At some point you may need a computed tomography (CAT or CT scan) or examination (magnetic resonance imaging or MRI). These tests show a "snapshot" of the inside of your body. Looking at these pictures, your doctor can determine whether there are tumors on the pituitary gland or other parts of your body.