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Cushing's Syndrome En Español (Spanish Version)Cushing's syndrome is a hormonal disorder. It is caused by prolonged exposure to the hormone cortisol. Hormones are chemicals in the body. Cortisol is a common hormone. In normal doses it helps the body manage stress and infection.
Prolonged or excess exposure to cortisol as a result of:
- Long-term use of corticosteroid hormones such as cortisone or prednisone
- Tumor or abnormality of the adrenal gland, which causes the body to produce excess cortisol
-
Tumor or abnormality of the pituitary gland, which causes the body to produce excess cortisol (in the case of a
pituitary tumor
,
it is called Cushing's disease)
- Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland produce hormones that trigger the syndrome
Pituitary and Adrenal Glands © 2011 Nucleus Medical Media, Inc.
Factors that increase your risk of Cushing's syndrome include:
- Chronic use of corticosteroid medicines
- Age: 20-50 years
- Sex: female (much more common in women)
Although symptoms may vary, common symptoms of Cushing's syndrome are:
- Weight gain of the upper body and trunk
- Face shaped like a moon
-
Skin changes:
- Darkening of the skin
- Purple stretch marks
- Easy bruising
- Excess hair growth or acne in women
-
Menstrual disorders, especially infrequent or
absent periods
- Diminished fertility and libido
- High blood pressure
- Water retention or swelling
-
High blood sugar or
diabetes
- Tiredness or fatigue
- Personality changes or mood swings
- Muscle weakness
- Osteoporosis
or brittle bones
- Skeletal delayed growth in children
- Increased thirst
- Frequent urination
- Psychosis
- Low back pain
The doctor will ask about your symptoms and medical history. A physical exam will be done. - 24-hour urinary free cortisol level—Urine is collected for 24 hours and tested.
- Late-evening cortisol saliva/blood level—Saliva or blood is collected around 11 pm and tested.
-
Dexamethasone suppression test—A synthetic cortisol called
dexamethasone
is taken by mouth; blood and urine samples may be taken overnight or over several days.
- CRH stimulation test
- ACTH level
- High-dose dexamethasone suppression test
These tests may show whether there is a tumor in the pituitary or adrenal glands or another area of the body. Common imaging tools include:
- MRI scan
—a test that uses magnetic waves to make pictures of the inside of the body
- CT scan
—a type of x-ray that uses a computer to make pictures of structures inside the body
- Chest x-ray
—which may detect tumors in the lungs
Treatment of Cushing's syndrome depends on the cause.
Treatments include:
- Surgical removal of tumor (most common treatment option)
- Surgical removal of part, all, or both adrenal glands
- Radiation for some persistent tumors
- Gradual withdrawal of cortisone-type drugs under close medical supervision
- Drugs that decrease cortisol production or block the functioning of other adrenal products
Work with your doctor to keep use of corticosteroid drugs to a minimum.
American Academy of Family Physicians Cushing's Support and Research Foundation Canadian Family Physician
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. 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
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. 2011;7(5):279-289.
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Hormones
. 2006;5:231-250.
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Last Reviewed September 2011
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