Cushing disease (also called Cushing's disease or hypercortisolism) occurs when your body makes too much cortisol, a hormone related to the body's stress response. It's a rare pituitary disorder that is progressive. That means that without treatment, it gets worse over time.
The most common cause of Cushing's syndrome is the long-term, high-dose use of the cortisol-like glucocorticoids. These medicines are used to treat other medical conditions, such as asthma link, rheumatoid arthritis link, and lupus link. Glucocorticoids are often injected into a joint to treat pain.
Symptoms of Cushing's syndrome
One of the main signs is weight gain and more body fat, such as: increased fat on your chest and tummy, but slim arms and legs. a build-up of fat on the back of your neck and shoulders, known as a "buffalo hump" a red, puffy, rounded face.
Cushing Disease: Cushing disease is a form of Cushing syndrome. Cushing disease occurs when a benign tumor in the pituitary gland causes the pituitary gland to produce too much ACTH, the hormone responsible for cortisol production. Too much ACTH in the body causes the adrenal glands to produce cortisol in high levels.
People with Cushing's syndrome may see their face get round ("moon face"), they gain weight in unusual ways, bruise easily or feel weak, tired and sad. Women and men may also notice fertility and other problems. CS is most often found in adults between the ages of 20 and 50.
Cushing's disease is fatal without treatment; the median survival if uncontrolled is about 4.5 years, Melmed said. “This truly is a metabolic, malignant disorder,” Melmed said. “The life expectancy today in patients who are not controlled is apparently no different from 1930.”
Untreated Cushing syndrome can be life-threatening. Fortunately, most people with the syndrome are treated and cured.
Vascular disease is the main cause of death in CS patients (2, 4, 8, 12, 14). Indeed, the risk of cardiovascular and cerebrovascular events is greater in patients with active CS as compared with the general population and persists during long-term follow-up, even after remission has been achieved (7, 14).
Diagnosis of Cushing's syndrome is based on a review of your medical history, physical examination and laboratory tests, which help to determine the presence of excess levels of cortisol. Often X-ray exams of the adrenal or pituitary glands are useful for locating tumors.
Treatment for Cushing's syndrome depends on its cause. Surgery may be needed to remove the tumor or the pituitary or adrenal glands. Other treatment may include radiation, chemotherapy, and use of certain hormone-inhibiting drugs.
Cushing disease may be caused by an overuse of corticosteroids, such as prednisone, or may be due to an underlying condition, such as an adrenal tumor, lung tumor, or pituitary tumor. Chronic stress and poor stress management can cause Cushing disease, as cortisol is the hormone we produce when we're stressed.
Today, virtually all people with Cushing's syndrome can be treated effectively, and many can be cured. Because Cushing's syndrome is potentially fatal if untreated, people with this condition should have regular medical care and follow their treatment plan closely.
Incidence: Cushing disease/syndrome is rare. About 10 to 15 new cases per million people are diagnosed in the U.S. each year. These numbers may not reflect the true number of people with this illness, though, because it's not uncommon for people to go undiagnosed. Age: It is typically found in people ages 20 to 50.
Endogenous ACTH concentrations:
Endogenous (originating from within the body) ACTH concentration can be measured in blood samples as a screening test for the diagnosis of Cushing's disease. With pituitary origin Cushing's disease an increased concentration of endogenous ACTH will be found in the blood.
Cushing syndrome caused by either an adrenal or pituitary tumor affects women five times more frequently than men. Symptoms commonly begin between 25 to 40 years of age. Men are affected 3 times more often than women by ectopic ACTH production that is caused by lung cancer, which occurs later in life.
The adrenal gland endocrine system includes the adrenal glands and pituitary gland. Signals from the pituitary gland stimulate the adrenal glands' production of cortisol. Cortisol levels are sensed by the pituitary gland. Too much of the hormone cortisol in your body causes Cushing syndrome.
Brain structural abnormalities related to Cushing's syndrome have been repeatedly found, including smaller hippocampal volumes, enlarged ventricles, and cerebral atrophy3.
Most cases of Cushing's syndrome can be cured, though it may take some time for your symptoms to ease up. The condition is more common in women than in men. It's most often seen in people ages 25-40.
Left untreated, Cushing's disease can ultimately be fatal, but fortunately there are effective treatments for the disorder. (See Diagnosing and Treating Cushing's Disease.)
It is much more common in women than men and while it can develop at any age, it tends to manifest between ages 25 to 55 years.
If treatment removes the source of excess cortisol, most of the symptoms of Cushing's syndrome disappear within 12 months. Osteoporosis begins to improve within six months and continues to improve over several years.
Cushing syndrome can possibly be fatal if you don't get treatment. Without treatment, hypercortisolism can cause health problems, including: Infections. Blood clots, especially in the lungs and legs.
Medications to control excessive production of cortisol at the adrenal gland include ketoconazole, mitotane (Lysodren) and metyrapone (Metopirone). Mifepristone (Korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance.