Cushing's syndrome

Cushing's syndrome is a pathological condition in which we find excess hormones of the adrenal cortex: aldosterone, cortisol and adrenal sex hormones (adrenal androgenes).

Causes of Cushing's syndrome

The most common cause is the excessive production of hormones by the enlargement of the cortex of the adrenal gland, growth of hormonally active tumors (adenomas) and malignant tumors (carcinomas) and some genetically determined hereditary diseases (Carney's complex). Cushing's syndrome is also caused by increased external intake of the mentioned hormones or medicines similar to them, in the presence of pituitary tumors or other tumors that stimulate the cortex of the adrenal gland (tumors that secrete adenocorticotropic hormone), the use of contraceptives that contain estrogens, etc. Women are 5 times more likely to get the disease than men.

Clinical presentation

The clinical preseantation depends on the anatomical involvement of the adrenal cortex and the type of hormones that are secreted in excess, with a note that there are often overlaps in symptomatology. An excess of aldosterone causes an increased level of sodium and a decreased level of potassium in the blood, along with the appearance of muscle stiffness and tingling in the extremities with an increase in blood pressure (arterial hypertension). High levels of cortisol cause an increased breakdown of building materials (fats, proteins and sugars), resulting in thin skin prone to cracking and bruising with the deterioration of bones and muscles and an increase in the level of fat in the blood. Fat tissue is increasingly deposited on the face, neck, back and abdomen. Excessive hairiness, acne and menstrual cycle disorder in women are the result of excess of sex hormones from the cortex of the adrenal glands. On the other hand, males experience a drop in libido and impotence because less sex hormones are secreted from the testicles. About 20% of patients have various psychological problems in the form of emotional lability, depression and anxiety disorders.

Diagnosis and treatment

The diagnostic procedure includes a specialist examination, laboratory and hormone tests and radiological imaging and nuclear medicine methods (ultrasound, CT, MR), which are useful in proving tumor changes.

Cushing's syndrome is treated etiologically and symptomatically.