Cushing syndrome
The name of a famous American neurosurgeon from early 20th century is used to describe the clinical signs and symptoms caused by long-term exposure to excessive amounts of the hormone cortisol. This can be caused either by using medication that contains steroids (e.g. arthritis or severe asthma) or by excess secretion of cortisol from the adrenal glands (see the following section for different terms used in each situation).
Whatever the cause of the condition, many signs and symptoms are similar. The differential diagnosis (i.e. the sequence of blood/urine tests and scans done to demonstrate the cause/mechanism or excess cortisol secretion) is complex and the endocrinologist will guide through this set-by-step process.
Possible causes:
Cushing disease: pituitary tumour producing ACTH
Cushing syndrome: adrenal tumour producing excess cortisol
Subclinical Cushing syndrome: weight gain (bunt other symptoms) and abnormal steroid profile
Ectopic Cushing syndrome: neuroendocrine tumour with ACTH secretion
Iatrogenic Cushing syndrome: therapeutic administration of high doses of glucocorticoids (prednisone, prednisolone, or dexamethasone).
Signs and symptoms:
change in body appearance: weight gain, ‘buffalo hump’, ‘moon face’
skin changes: thinning, fragility, acne, striae, hirsutism
general symptoms: fatigue, slow healing, increased risk of infections, poor BM control, hypertension
psychological symptoms: depression, anxiety, irritability, cognitive difficulties, loss of libido