Cushing’s syndrome

What is Cushing’s syndrome?

Cushing’s syndrome is a disease that occurs due to chronic excessive production of adrenocorticotropic hormone (ACTH), which is naturally synthesized in the human body, but can also be introduced during pharmacological therapies to resolve inflammatory diseases. This hormone, under optimal conditions, is responsible for the physiological response to stress and multiple other essential functions. However, when its levels are chronically increased, indifferent alterations do not occur.

What are the symptoms of Cushing’s syndrome?

The disease presents as a complex of symptoms. The most important changes are accumulated obesity in the trunk, especially in the cervical and supraclavicular areas, causing the so-called lunar face, i.e., swollen, rounded, and a thinning of the extremities with atrophy of the muscles. The pathology is also accompanied by hypertension, osteoporosis, skin that develops purple striae on the abdomen, hematomas evident throughout the rest of the body and reduced immune defenses that cause frequent infections. In women, on the other hand, it may present with cycle irregularities, hypertrichosis and acne. Finally, in children, the disease causes a blockage of height gain.

Diagnosis of Cushing’s syndrome

Diagnosis of the pathology is difficult in the initial stage, given the nature of the symptoms which can be associated with different diseases. A test is performed, the results of which are particularly reliable, as they are obtained by urine analysis for free urinary cortisol, following the intake of anti-inflammatory steroids. It will then be necessary to understand whether it is an ACTH-dependent or an ACTH-independent form. Depending on the case, it may be necessary to perform MRI, coronary, or stimulation or inhibition tests, such as the CRH test that inhibits the system by prescribing an anti-inflammatory steroid drug.

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What are the causes of Cushing’s syndrome?

The main cause of the pathology, when autoimmune, is an excessive production of adrenocorticotropic hormone (ACTH) by the pituitary gland, a gland located in the brain and whose function is the synthesis of different types of hormones. When this gland develops a benign tumor, the synthesis of the hormone in question is compromised, profoundly influencing various functions of the human body. Then, there are cases in which the syndrome develops due to prolonged intake of anti-inflammatory and immunosuppressive drugs that affect the secretion of the ACTH hormone, similar to pituitary cancer.

Can it be prevented?

The only way to prevent the disorder, only in cases of exogenous origin, is to limit the use of steroid hormone-based drugs. Obviously, only a specialist will be able to evaluate the need for treatment on a case-by-case basis.

Treatments for Cushing’s syndrome

The disease resolves successfully if its clear origin is identified. In forms of exogenous origin, therefore, with prolonged use of medications, the specialist will provide interruption or modification of therapy. On the other hand, when the disease is autoimmune, surgery or radiotherapy is performed to remove the tumors that cause hormonal insufficiency. For patients for whom surgery is not an option, the specialist will prescribe a specific therapy.

Which specialist to contact?

The specialist who deals with the diagnosis and therapy of Cushing’s syndrome is the endocrinologist.