Cushing's disease

Cushing's disease refers to a condition characterized by an overproduction of the hormone cortisol by the adrenal glands, usually caused by a pituitary gland tumor.<ref>Newell-Price, J,

 The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states, 
 Endocrine Reviews, 
 1998,
 Vol. 19(Issue: 5),
 pp. 647–672,
 DOI: 10.1210/edrv.19.5.0341,</ref> This hormonal imbalance can result in a variety of health issues, from physical changes to psychological disturbances.

Straie with cushing syndrome new photo

Overview

Cushing's disease is a subtype of Cushing's syndrome, a condition characterized by an excess of cortisol, a hormone that plays a crucial role in numerous bodily functions. The term "Cushing's disease" is specifically used when the excess cortisol is caused by a pituitary adenoma.<ref>Arnaldi, G,

 Diagnosis and complications of Cushing's syndrome: a consensus statement, 
 Journal of Clinical Endocrinology & Metabolism, 
 2003,
 Vol. 88(Issue: 12),
 pp. 5593–5602,
 DOI: 10.1210/jc.2003-030871,</ref>

Symptoms and Clinical Presentation

Common symptoms of Cushing's disease include weight gain, particularly around the abdomen and face, skin changes such as purple stretch marks and easy bruising, muscle weakness, mood changes, and, in women, irregular menstruation.<ref>Nieman, LK,

 The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline, 
 Journal of Clinical Endocrinology & Metabolism, 
 2008,
 Vol. 93(Issue: 5),
 pp. 1526–1540,
 DOI: 10.1210/jc.2008-0125,</ref>

Pathophysiology

In most cases of Cushing's disease, a tumor in the pituitary gland, known as a pituitary adenoma, produces an excess of adrenocorticotropic hormone (ACTH). This, in turn, stimulates the adrenal glands to produce more cortisol than the body needs.<ref>Storr, HL,

 Clinical and endocrine responses to pituitary radiotherapy in pediatric Cushing's disease: an effective second-line treatment, 
 Journal of Clinical Endocrinology & Metabolism, 
 2005,
 Vol. 90(Issue: 11),
 pp. 6123–6127,
 DOI: 10.1210/jc.2005-1189,</ref>

Diagnosis

Diagnosing Cushing's disease can be challenging due to the variability of symptoms and their overlap with other conditions. It often involves blood and urine tests to measure cortisol levels, as well as imaging tests such as MRI to identify potential tumors. A definitive diagnosis usually requires a combination of clinical findings and laboratory testing.<ref>Findling, JW,

 Biochemical testing for the diagnosis of Cushing's syndrome, 
 Endocrine Practice, 
 2007,
 Vol. 13(Issue: Suppl 2),
 pp. 1–22,</ref>

Treatment

The primary treatment for Cushing's disease is surgery to remove the pituitary tumor.<ref>Patil, CG,

 National trends in surgical procedures for pituitary tumors: 1993–2002, 
 Neurosurgical Focus, 
 2007,
 Vol. 23,
 
 DOI: 10.3171/FOC-07/12/E9,</ref> This is typically done through a procedure known as transsphenoidal surgery, where the surgeon accesses the pituitary gland via the nose and sinuses.<ref>Starke, RM, 
 Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission, 
 Journal of Clinical Endocrinology & Metabolism, 
 2013,
 Vol. 98(Issue: 8),
 pp. 3190–3198,
 DOI: 10.1210/jc.2013-1036,</ref> In cases where surgery is not possible or does not fully remove the tumor, additional treatments such as radiation therapy or medication may be used.<ref>Imaki, T, 
 Differential diagnosis of Cushing's syndrome: results of a multicenter study in Japan, 
 Endocrine Journal, 
 2003,
 Vol. 50(Issue: 6),
 pp. 753–761,
 DOI: 10.1507/endocrj.50.753,</ref>

Prognosis

The prognosis for individuals with Cushing's disease varies depending on the severity of the disease and the success of treatment. If the tumor can be fully removed, there is a good chance of recovery, although it may take time for the body to return to normal cortisol production. In cases where the tumor cannot be fully removed, or if it returns, further treatment may be necessary and the prognosis can be less favorable.<ref>Storr, HL,

 Paediatric Cushing's disease: epidemiology, pathogenesis, clinical features, diagnosis, and therapy, 
 Endocrine Journal, 
 2006,
 Vol. 53(Issue: 5),
 pp. 611–621,
 DOI: 10.1507/endocrj.KR-93,</ref>

Epidemiology

Cushing's disease is relatively rare, with an estimated prevalence of 2 to 3 cases per million people per year. It most commonly affects adults between the ages of 20 and 50 and is more common in women than men.<ref>Newell-Price, J,

 The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states, 
 Endocrine Reviews, 
 1998,
 Vol. 19(Issue: 5),
 pp. 647–672,
 DOI: 10.1210/edrv.19.5.0341,</ref>

See Also

• Cushing's syndrome
• Pituitary adenoma
• Adrenal gland
• Cortisol

References

{Authority control}}

This article is a medical stub. You can help WikiMD by expanding it!
Most recent articles Ongoing trials	Wikipedia