What is Cushing syndrome? What are the symptoms and treatments?

Cushing syndrome is a condition that occurs as a result of excessive cortisol hormone production in the body. Cortisol is a hormone normally made by the adrenal glands and is essential for life. This hormone enables a person to respond to stressful situations such as illness. It has an effect on almost all body tissues. Producing too much cortisol in the body is referred to as Cushing’s syndrome regardless of the cause.


Cushing’s syndrome symptoms

The symptoms of Cushing’s syndrome show up in a wide range of patients, from mild to severe. The most common symptom in adults is weight gain, which is particularly pronounced in the trunk. Other common symptoms can be listed as hypertension, memory problems, loss of attention and concentration.

Excessive increase in cortisol hormone causes protein loss in body tissues. Protein loss results in muscle weakness. Fat tissue deposits are seen in various parts of the body. Especially as a result of the accumulation of the face, the situation called buffalo hump occurs as a result of the accumulation between the face and the shoulders. Some other symptoms of Chusing syndrome;

• Unrest
• Insomnia
• Weakness
• Headache
• Depressed mood
• Emotional loss of control
• Increase in acne
• Facial rash
• Osteoclasis
• Easy breaks in bones
• Excessive thirst
• Frequent urination
• High blood sugar levels
• Obesity as a result of excessive weight gain
• Recurrent infections
• Thinning and easy bruising
• Pink or purple stretch marks on the abdomen, hips, breasts, and arms
• Delay in healing wounds and infections
• Excessive hair growth in women
• Irregular period
• Decreased sexual desire
• Erectile dysfunction in men
• Reduced fertility
• It can be listed as a slowdown in growth in children.



Causes of Cushing syndrome

The most common cause of Cushing’s syndrome is the long-term use of steroid-containing drugs at high doses. These drugs may need to be used in high doses after organ transplants, in the treatment of conditions such as lupus or rheumatoid arthritis. Since inhalers used in asthma or cream-form steroids used for urticaria are in low doses, they do not cause Cushing syndrome. Other causes of the disease;

• Tumors of the pituitary gland in the brain that cause high amounts of ACTH hormone production
• Some tumors of the lung, pancreas, and thyroid gland
• It is listed as overwork or tumors of the adrenal gland.

Some pituitary tumors produce a hormone called adrenocorticotropic hormone (ACTH) that stimulates the adrenal glands and causes them to produce excess cortisol. The condition that occurs in this way is called Cushing’s disease. These pituitary tumors are mostly benign and usually do not cause cancer. Some individuals are genetically predisposed to tumoral formations that cause Cushing syndrome.



How is Cushing’s syndrome diagnosed?

For diagnosis, your doctor will first ask detailed questions about your illness. Then he does a detailed physical examination. If he suspects Cushing’s syndrome, he or she will ask you to have some tests.

Free cortisol level in 24-hour urine: This test is based on the measurement of free cortisol level by collecting your urine for 24 hours.

Dexamethasone suppression test: In this test, you are asked to take a pill containing dexamethasone at 11 o’clock at night. Your blood cortisol level will be checked the next morning.

Midnight salivary cortisol level measurement: This test is a midnight test. The salivary cortisol level is checked.

If Cushing’s syndrome is diagnosed as a result of the tests performed, further examinations such as imaging of the adrenal gland and brain MRI are performed to find the cause.



Cushing’s syndrome treatment methods

• The goal of treatments for Cushing’s syndrome is to lower the high cortisol levels in your body. Treatment is planned according to the cause of the disease.
• If the cause of Cushing’s syndrome is prolonged use of corticosteroid drugs, your doctor may consider reducing the dosage of the drug over a period of time.
• If the cause of the disease is caused by a tumor, surgical treatment options are evaluated.
• If the tumoral tissue cannot be surgically removed completely, radiotherapy is applied.
• If radiotherapy is not sufficient, drugs that suppress cortisol production are used.

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