Cushing's syndrome is a disorder that develops due to prolonged exposure of different tissues to high level of cortisol. Cortisol is one of several hormones produced by the adrenal gland. The condition is also known under the name hypercortisolism. It is frequent in people between the age of 20 and 50. The risk for Cushing's syndrome is high in individuals suffering from type 2 diabetes, obese people as well as those with poorly controlled blood glucose. Cushing's syndrome is also frequent in patients suffering from high blood pressure.
Cushing's Syndrome Clinical Characteristics
There are numerous symptoms and signs of Cushing's syndrome. However, most patients develop the most typical ones. Such patients are, for instance, obese but the fat predominantly accumulates in the upper part of the body. Furthermore, their face is rounded and accumulation of fat tissue at the back of the neck forms a hump. Arms and legs of these patients remain thin. Children suffering from Cushing's syndrome are obese and grow slower comparing to their peers.
The skin in such individuals is fragile, thin and susceptible to bruises and stretch marks. Stretch marks are wide and large affecting the abdomen, thighs, buttocks, arms and breasts. Bones become weak which increases the risk of fractures. Women additionally suffer from hirsutism and have irregular periods while men may end up with decreased fertility and erectile problems.
Apart from the previously mentioned Cushing's syndrome is also responsible for sever fatigue, muscle weakness, hypertension, hyperglycemia, increased thirst and urination and a variety of mental changes.
Cushing's Syndrome Causes
The excess of cortisol is what causes all the symptoms and signs of Cushing's syndrome. The problem may be endogenous meaning that the body produces too much cortisol or it is exogenous. In the second case the disorder generally results from intake of glucocorticoids, medications prescribed for other medical conditions such as asthma, rheumatoid arthritis, lupus etc.
In order for the adrenal glands to produce cortisol, they need to be stimulated. This is achieved by corticotropin-releasing hormone (CRH) released by the hypothalamus and adrenocorticotropic hormone (ACTH), one of several hormones produced by the pituitary gland. Optimal level of cortisol in the blood influences the pituitary gland and the hypothalamus to release less of their hormones. However, if there is some problem in the adrenal glands, the pituitary gland or the hypothalamus, one may eventually end up with Cushing's syndrome.
For example, Cushing's syndrome affects people suffering from pituitary adenomas (those that produce extra ACTH), ectopic ACTH syndrome (certain cancerous tumors located outside the pituitary gland which also produce large amounts of ACTH) and hormonally active adrenal tumors. Finally, in rare cases Cushing's syndrome results from an inherited tendency to endocrine gland tumors which is medically known as familiar Cushing's syndrome.