The nurse understands that the cause of cushing syndrome is most commonly due to:
|
Cushing’s syndrome is a group of symptoms caused by too much cortisol in your body. It can be caused by long-term use of corticosteroid medications or by a non-cancerous tumour in your pituitary or adrenal glands. Show
Key points
What causes Cushing’s syndrome?Cushing’s syndrome is caused by too much cortisol in your body. Your body can build up too much cortisol in two ways:
Long-term use of corticosteroid medicationsCorticosteroid medications (e.g. prednisone, hydrocortisone) contain a man-made version of cortisol and are used to treat many conditions associated with inflammation, such as rheumatoid arthritis, lupus or asthma, or they can be used to prevent your body from rejecting a transplanted organ. Corticosteroids can be taken orally, inhaled (e.g. for asthma) or topically (put on your skin). Short-term use of oral corticosteroids and the use of inhaled and topical corticosteroids carry a very low risk of developing Cushing’s syndrome. Long-term use of oral corticosteroids carry a higher risk. Adrenal glands producing too much cortisolCortisol is a hormone, which means it is made in one part of your body but causes an effect in another part. Cortisol is made by your adrenal glands, which sit on top of your kidneys. Adrenal gland tumourA tumour in your adrenal glands can cause too many adrenal cells to produce cortisol. This causes high levels of cortisol in your blood. Pituitary gland tumourYour adrenal glands need to be told how much cortisol to make. Your pituitary gland, which is found just below your brain, has the job of telling your adrenal glands how much cortisol your body needs. This is a four-step process:
A tumour in your pituitary gland is called Cushing’s disease. A tumour elsewhere in your bodyIn very rare cases, a tumour in another part of your body, often the lungs, starts producing ACTH, causing your adrenal glands to produce more cortisol than is needed. Cushing’s syndrome caused by a tumour is five times more common in women than men and it usually occurs between the ages of 25–40. What are the symptoms of Cushing’s syndrome?There are many symptoms of Cushing’s syndrome and you may only have a few. Symptoms vary from person to person and can range from mild to severe. The most common symptoms are:
Cushing’s syndrome can also cause changes to your skin, bones, muscles and mood.
Other symptoms include diabetes, irregular periods in women and an increase in infections. How is Cushing's syndrome diagnosed?Often the diagnosis of Cushing’s syndrome can take some time, as many of the symptoms can be caused by other disorders. If your doctor suspects Cushing’s syndrome, you may need to have a blood test, a urine test and a saliva test. Blood testYou may be sent for a blood test that measures how much cortisol you have in your blood.
Urine testYou may be asked to collect your urine (wee) over 24 hours. The amount of cortisol in your urine is measured. Saliva testCushing’s syndrome can cause increased levels of cortisol at night. You might be asked to collect a sample of your saliva late at night. If you are diagnosed with Cushing’s syndrome due to a tumour, further testing will be needed to find out where the tumour is. These may include an MRI, ultrasound or further blood tests. What is the treatment for Cushing's syndrome?Treatment depends on what is causing your high level of cortisol. The goal of treatment is to reduce the amount of cortisol. Corticosteroid medication useIf your corticosteroid medication is causing Cushing’s syndrome your doctor may try lowering your dose of corticosteroid medication gradually to minimise symptoms while still treating the disease it is being used for, by trying you on a different, non-corticosteroid medication. It is important not to reduce the dose of your corticosteroid medication or stop taking it on your own. Do so only under your doctor's supervision. Stopping these medications suddenly could lead to low cortisol levels which may be harmful. Slowly tapering off corticosteroid medications allows your body to restart normal cortisol production. Pituitary or adrenal gland tumourIf a pituitary or adrenal gland tumour is causing Cushing’s syndrome your treatment options may be surgery to remove the tumour or radiation or chemotherapy. What self-care can I do if I have Cushing's syndrome?
Cushing Syndrome - causes, symptoms, diagnosis, treatment, pathology(Osmosis, US, 2017) Learn moreCushing's syndrome DermNet
NZ References
Information for healthcare providersDexamethasone suppression test Canterbury Health
Laboratories What is the most common cause of Cushings syndrome?The most common is a noncancerous tumor of the adrenal cortex, called an adrenal adenoma, but only a small fraction of adenomas produce too much cortisol. Cancerous tumors of the adrenal cortex are rare, but they can cause Cushing syndrome as well.
What is Cushing's syndrome characterized by?Cushing disease is an endocrine disorder characterized by excessive adrenocorticotropic hormone (ACTH) production by the anterior pituitary, leading to the release of an excess of cortisol from the adrenal glands.
What is the pathophysiological cause of Cushing syndrome?Cushing syndrome is caused by prolonged exposure to high circulating levels of cortisol. The most common cause of cushingoid features is iatrogenic corticosteroid use, while some herbal preparations can also increase circulating corticosteroid levels leading to Cushing syndrome.
|
