CUSHINGS SYNDROME

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Definition

Cushing syndrome is a disease that occurs when your body produces too much of the hormone cortisol. It may also occur if you take too much cortisol or other steroid hormones.

See also:

• Cushing's disease (pituitary Cushing's)
• Cushing syndrome caused by adrenal tumor
• Cushing syndrome - exogenous
• Ectopic Cushing syndrome

Alternative Names

Hypercortisolism

Causes, incidence, and risk factors

The most common cause of Cushing syndrome is side effects from taking anti-inflammatory steroid medications for conditions such as asthma and rheumatoid arthritis.

The second most common cause is Cushing's disease, which occurs when the pituitary gland makes too much of the hormone ACTH. ACTH stimulates the adrenal glands to produce cortisol.

Cushing's disease affects women more often than men.

Cushing syndrome can also be caused by the following:

• Tumor of the pituitary gland or adrenal gland
• Tumor elsewhere in the body (ectopic Cushing syndrome)

Symptoms

• Abdomen that sticks out and thin arms and legs (central obesity)
• Acne or skin infections
• Backache
• Collection of fat between the shoulders (buffalo hump)
• Hair growth on the face
• Headache
• Impotence (men)
• Menstrual cycle stops (women)
• Mental changes
• Purple marks on the skin of the abdomen, thighs, and breasts
• Round, red, and full face (moon face)
• Thin skin with easy bruising
• Weakness
• Weight gain (unintentional)

Other symptoms that may occur with this disease:

• Bone pain or tenderness
• Fatigue
• High blood pressure
• Muscle atrophy
• Red spots on the skin
• Skin blushing or flushing

Signs and tests

Blood sugar and white blood cell counts may be high. Potassium level may be low.

Laboratory tests are done to confirm high cortisol level. These include:

• Blood test to check cortisol level
• Dexamethasone suppression test
• Urine tests to check cortisol levels

Tests to determine the cause may include:

• Abdominal CT
• ACTH test
• Pituitary MRI

Reviewer Info: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 03/18/2008