| General Illness Information |
Common Name: |
Cushing's
Disease, Cushing's syndrome. |
|
Medical Term:
|
Cushing's Disease, Cushing's syndrome |
| Description: |
Clinical abnormalities
associated with chronic exposure to excessive amounts of cortisol. |
| Causes: |
The
most frequent cause is prolonged use of steroid medications
(Cortisone, or ACTH)
Other causes:
ACTH-secreting pituitary tumor
Ectopic ACTH production (e.g.,
small-cell carcinoma of lung, bronchial carcinoid)
Endogenous ACTH-independent
hypercortisolism:
Adrenal adenoma
Adrenal carcinoma
Macro/micro nodular
hyperplasia of the adrenal gland. |
| Prevention: |
Avoid excessive corticosteroid treatment when
possible. |
| Signs
& Symptoms |
|
Moon face
Increased fat tissue in
neck and trunk
Central weight gain
Emotional ups and downs
Hypertension
Osteoporosis
Purple striae on the skin
Diabetes.
Muscle weakness due to
loss of muscle mass from increased catabolism
Skeletal growth
retardation in children
Easy bruising
Hirsutism
|
|
| Risk Factors |
|
Any medical problem
requiring prolonged use of corticosteroids
Pituitary tumor
Adrenal mass
|
| Diagnosis & Treatment |
|
Blood tests will reveal abnormalities in:
24 hour urinary cortisol
Plasma cortisol (am and
pm)
Plasma ACTH
concentration
Blood sugar levels, electrolytes,
lipids.
Imaging:
Chest films
X-rays of the lumbar
spine - osteoporosis is common
If pituitary tumor
suspected - pituitary MRI scan
If adrenal disease
suspected - abdominal CT scan
If ectopic
ACTH-secretion suspected - chest CT scan
|
| General
Measures: |
|
Treatment depends on cause.
Surgery is the treatment of choice; persistent disease may
require - radiation, drug therapy, or surgery |
|
|
|
| Medications: |
|
Anti-adrenal drugs have not been successful,
but are used by skilled physicians when all other treatments
have failed.
|
|
| Activity: |
|
As tolerated, in accordance with symptoms and
treatment.
|
|
| Diet: |
|
Potassium supplements
High protein diet
|
|
| Possible
Complications : |
|
Osteoporosis
Increased susceptibility
to infections
Hirsutism
Metastases of malignant
tumors
|
|
| Prognosis |
|
Guardedly favorable
prognosis with surgery
|
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