Perspective - Journal of Clinical Endocrinology Research (2021) Volume 4, Issue 3
Brief note on cushing’s syndrome.
Alfredo De Martino*
Department of Endocrinology and Diabetes, University of Birmingham, Birmingham, UK
- Corresponding Author:
- Alfredo De Martino
Department of Endocrinology and Diabetes
University of Birmingham
E-mail: [email protected]
Accepted date: 03 December, 2021
Citation: Martino AD. Brief note on cushing’s syndrome. J Clin Endocrinol Res. 2021; 4(3):1.
Cushing's syndrome occurs when the body has too much cortisol hormone over time. This can be caused by taking oral corticosteroids. Your body may be producing excess cortisol. Too much cortisol can cause some of the characteristic signs of Cushing's syndrome. There are greasy humps between the shoulders, a round face, and pink or purple stretch marks on the skin. Cushing's syndrome can also cause high blood pressure, bone loss, and sometimes type 2 Diabetes.
The most common symptoms of this condition are:
• Weight gain
• Fat accumulates especially on the middle face (causing a round moon-shaped face) and the shoulders and upper back (causing buffalo humps).
• Purple stretch marks on chest, arms, stomach and thighs
• Thin bruising-prone skin
• Difficult to heal skin injuries
Cushing's syndrome can result from any cause of elevated glucocorticoid levels, whether due to medication or internal processes. However, some sources do not consider the condition caused by glucocorticoid drugs to be the actual "Cushing's syndrome" and instead use the term "Cushing's syndrome" to Adrenocorticotropic Hormone (ACTH) ( Explains the side effects of drugs that mimic endogenous pituitary tumors leading to overproduction of adrenocorticotropic hormone). Excess ACTH stimulates the adrenal cortex to produce high levels of cortisol, causing pathology and Cushing’s syndrome.
The most common cause of Cushing's syndrome is the use of glucocorticoids prescribed to treat other conditions (iatrogenic Cushing's syndrome). Glucocorticoids are used to treat various symptoms such as asthma and rheumatoid arthritis, and are also used for immunosuppression after organ transplantation. Synthetic ACTH can also be given, but ACTH is less commonly prescribed due to reduced costs and benefits.
Endogenous Cushing's syndrome results from a disruption of the body's cortisol-secreting system. ACTH is normally released from the pituitary gland when needed to stimulate the release of cortisol from the adrenal glands.
In pituitary Cushing, benign pituitary adenomas secrete ACTH. It is also known as Cushing's disease and is the cause of 70% of endogenous Cushing's syndrome.
In adrenal Cushing, excess cortisol is produced by adrenal tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia.
Diagnosis of Cushing’s Syndrome
The diagnosis of Cushing's syndrome is based on clinical suspicion combined with a patient's medical history review, physical examination, and laboratory tests to determine the presence of excess cortisol levels. Patients with suspected Cushing's syndrome must first present with symptoms suggestive of excessive cortisol production and increased 24- hour urinary excretion of cortisol. When assessing the physical characteristics of Cushing's syndrome, it is often useful to compare old and recent photographs to reveal the classic facial and body appearance changes associated with this condition.
24-hour urinary cortisol test: This test measures the amount of cortisol in the urine in micrograms. Your doctor will let you collect your urine for 24 hours. 50-100 milligrams per day is more and can be treat Cushing's syndrome.
Midnight salivary cortisol test: Cortisol levels are known to be very low in the morning and low late at night. This test checks cortisol levels from 11:00 pm to 12:00 am. If you have Cushing's syndrome, your cortisol levels will be abnormally high during this time.