CUSHING'S SYNDROME
What are the Symptoms of Cushing's Syndrome?
Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs. Children tend to be obese with slowed growth rates. Other symptoms appear in the skin, which becomes fragile and thin. It bruises easily and heals poorly. Purplish pink stretch marks may appear on the abdomen, thighs, buttocks, arms and breasts. The bones are weakened, and routine activities such as bending, lifting or rising from a chair may lead to backaches, rib and spinal column fractures.
Most people have severe fatigue, weak muscles, high blood pressure and high blood sugar. Irritability, anxiety and depression are common.
Women usually have excess hair growth on their faces, necks, chests, abdomens, and thighs. Their menstrual periods may become irregular or stop. Men have decreased fertility with diminished or absent desire for sex.
How is Cushing's Syndrome Diagnosed?
Diagnosis is based on a review of the patient's medical history, physical examination and laboratory tests. Often x-ray exams of the adrenal or pituitary glands are useful for locating tumors. These tests help to determine if excess levels of cortisol are present and why.
How is Cushing's Syndrome Treated?
Treatment depends on the specific reason for cortisol excess
and may include surgery, radiation, chemotherapy or the use
of cortisol-inhibiting drugs. If the cause is long-term use
of glucocorticoid hormones to treat another disorder, the doctor
will gradually reduce the dosage to the lowest dose adequate
for control of that disorder. Once control is established, the
daily dose of glucocorticoid hormones may be doubled and given
on alternate days to lessen side effects.
Several therapies are available to treat the ACTH-secreting
pituitary adenomas of Cushing's disease. The most widely used
treatment is surgical removal of the tumor.
