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