Which patient has the greatest risk factor towards developing Cushing syndrome?

Left untreated, Cushing syndrome can result in exaggerated facial roundness, weight gain around the midsection and upper back, thinning of the arms and legs, easy bruising, and stretch marks.

Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid medication. Or your body might produce too much cortisol.

Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.

Treatments for Cushing syndrome can return your body's cortisol levels to normal and improve your symptoms. The earlier treatment begins, the better your chances for recovery.

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Symptoms

The signs and symptoms of Cushing syndrome can vary depending on the levels of excess cortisol.

Common signs and symptoms of Cushing syndrome

  • Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
  • Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
  • Thinning, fragile skin that bruises easily
  • Slow healing of cuts, insect bites and infections
  • Acne

Signs and symptoms women with Cushing syndrome may experience

  • Thicker or more visible body and facial hair (hirsutism)
  • Irregular or absent menstrual periods

Signs and symptoms men with Cushing syndrome may experience

  • Decreased sex drive
  • Decreased fertility
  • Erectile dysfunction

Other possible signs and symptoms of Cushing syndrome

  • Severe fatigue
  • Muscle weakness
  • Depression, anxiety and irritability
  • Loss of emotional control
  • Cognitive difficulties
  • New or worsened high blood pressure
  • Headache
  • Infections
  • Skin darkening
  • Bone loss, leading to fractures over time
  • In children, impaired growth

When to see a doctor

Contact your doctor if you have symptoms that suggest Cushing syndrome, especially if you're taking corticosteroid medication to treat a condition such as asthma, arthritis or inflammatory bowel disease.

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Cushing's syndrome is a rare problem that happens when you have too much of the hormone cortisol in your body. Cortisol is especially important in controlling blood pressure and metabolism. But it affects almost every area of your body. Normally, your body keeps cortisol in in balance through a complex system that involves your hypothalamus, pituitary gland, and adrenal glands.

Stanford is a global referral center for the diagnosis and management of Cushing’s disease with novel medications and pioneering surgical approaches for the pituitary gland.

We deliver effective, minimally invasive treatments in a caring environment. Call 310-267-7838 to connect with an expert in endocrine surgery.

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What is Cushing's syndrome (hypercortisolism)?

Definition:
Cushing's syndrome is a disease caused by increased production of cortisol, or by excessive use of cortisol or other steroid hormones.

Alternative Names: Hypercortisolism

Causes, incidence, and risk factors:
Cushing's syndrome is a condition that results from an excess of cortisol, a hormone produced by the adrenal glands. The most common cause of Cushing's syndrome is Cushing's disease, caused by excessive production of the hormone ACTH by the pituitary gland. ACTH stimulates the adrenal glands to produce cortisol.

Cushing's syndrome can be caused by a tumor of the pituitary gland, a tumor of the adrenal gland, a tumor somewhere other than the pituitary or adrenal glands (ectopic Cushing's syndrome), or by long-term use of corticosteroids (drugs commonly used to treat conditions such as rheumatoid arthritis and asthma).

Risk factors for Cushing's syndrome are adrenal or pituitary tumors, long-term therapy with corticosteroids, and being female.

See also:

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

Symptoms:

  • moon face (round, red, and full)
  • buffalo hump (a collection of fat between the shoulders)
  • central obesity with protruding abdomen and thin extremities
  • weight gain (unintentional)
  • weakness
  • backache
  • headache
  • acne or superficial skin infections
  • thin skin with easy bruising
  • thirst
  • increased urination
  • purple striations on the skin of the abdomen, thighs, and breasts
  • mental changes
  • impotence or cessation of menses
  • facial hair growth

Additional symptoms that may be associated with this disease:

  • skin spots, red
  • skin blushing / flushing
  • muscle atrophy
  • fatigue
  • bone pain or tenderness
  • high blood pressure

Signs and tests:

Tests to confirm high cortisol level:

  • cortisol, urine
  • dexamethasone suppression test
  • serial serum cortisol levels

Tests to determine the cause:

  • ACTH
  • cranial MRI or cranial CT scan may show pituitary tumor
  • abdominal CT may show adrenal mass
  • General findings:
  • glucose test is elevated
  • potassium test may be low
  • white blood cell count may be elevated

Treatment:
Treatment depends upon the cause of the disorder. In Cushing's syndrome caused by a tumor secreting ACTH, removal of the tumor is the best way to treat the Cushing's syndrome. Cortisol replacement therapy is needed after surgery until cortisol production resumes. In some cases, life-long therapy with cortisone drugs becomes necessary.

Which of the following would most likely cause Cushing syndrome?

Cushing disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. The pituitary gland is located just below the base of the brain. A type of pituitary tumor called an adenoma is the most common cause.

Which condition is a predisposing factor for Cushing's syndrome?

Risk factors for Cushing's syndrome are adrenal or pituitary tumors, long-term therapy with corticosteroids, and being female.

Is being male a risk factor for Cushing's disease?

Cushing's disease (CD) is remarkably prevalent among females; however, more severe clinical presentation and adverse outcomes have been found in males.