Cushing's syndrome develops when the body for a long time exposed to high levels of the hormone cortisol. The most common cause of Cushing's syndrome, which is sometimes also called hypercortisolism, is the use of corticosteroids. It can also develop if the body produces too much cortisol.
Symptoms
Cushing's syndrome symptoms will vary depending on many factors, including the sex and general health of the patient. The most common symptoms of Cushing's syndrome are:
- The increase in weight and body fat, particularly in the upper back and on the face;
- The appearance of stretch marks on the abdomen, thighs, chest and arms;
- Thinning skin, easy bruising;
- Slow wound healing;
- The slow recovery from infectious diseases;
- Acne.
Women Cushing's syndrome can cause facial hair growth and menstrual disorders. In men, it can cause loss of libido, erectile dysfunction and impaired fertility.
Several less Cushing's syndrome causes the following symptoms characteristic of both sexes:
- Fatigue;
- Muscle weakness;
- Depression, anxiety
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and irritability
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;
- The weakening of control over emotions;
- Thought disorders;
- High blood pressure;
- Glucose intolerance, which can lead to diabetes;
- Headache;
- Reduction of bone density, which can lead to fractures even with minor injuries.
When to see a doctor
If you are taking corticosteroids for the treatment of disorders such as asthma, arthritis
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or inflammatory bowel disease
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and notice at any symptoms similar to the symptoms of Cushing's syndrome, see your doctor. Even if you do not take these drugs if you notice such symptoms should seek professional advice.
Causes
The main cause of Cushing's syndrome is excessively high levels of cortisol, a hormone which is produced by the adrenal glands.
Cortisol has many functions, for example, helps to regulate blood pressure and maintain normal functioning of the cardiovascular system. It is also involved in the body's response to stress and to manage the process of processing of proteins, carbohydrates and fats into energy. Excess of this hormone, however, is not useful for the organism.
Long-term use of corticosteroids may lead to the development of exogenous Cushing's syndrome. These drugs, such as prednisone, have the same effect as cortisol. As the therapeutic dose corticosteroids often exceed the amount of cortisol daily body needs arises hormone excess, resulting eventually develops Cushing's syndrome.
If the body produces excessive amounts of cortisol, developing endogenous Cushing's syndrome. This may occur as a result of excessive activity of one or both of the adrenal gland, or due to overproduction of adrenocorticotropic hormone (ACTH), which regulates the production of cortisol. In such cases of Cushing's syndrome may be associated with the following problems:
- The tumor of the pituitary gland. A benign tumor of the pituitary gland may be excessive secretion of ACTH, which is why the adrenal glands will produce more cortisol. These tumors are most common in women. The tumor of the pituitary gland - is the most common cause of endogenous Cushing's syndrome.
- Ectopic ACTH-secreting tumors. In rare cases, the organs that normally do not produce ACTH, developing a tumor that begins in excess secretion of this hormone that causes the development of Cushing's syndrome. These tumors are cancerous or benign, most often formed in the lungs, pancreas, thyroid, and thymus.
- Diseases of the adrenal glands. The most common of these diseases is a benign tumor of the adrenal cortex or adrenal adenoma. Cancerous tumors of the adrenal glands are rare, but they can cause the development of Cushing's syndrome.
- Heredity. Sometimes the tendency to develop tumors in the glands of the endocrine system is transmitted to humans by inheritance; One consequence of this may also be Cushing's syndrome.
Complications
Complications of Cushing's syndrome may include:
- Osteoporosis;
- Hypertension;
- Diabetes;
- Frequent infections;
- Reduced muscle strength.
Diagnostics
Diagnosing Cushing's syndrome, especially endogenous syndrome can be difficult - many diseases have similar signs and symptoms. Primarily the doctor determines the external symptoms of the disease. Then, use the following diagnostic methods:
- Analysis of blood and urine, by means of which determines the level of cortisol.
- Analysis of saliva. Normally, cortisol levels rise and fall throughout the day; Cushing's syndrome has been a significant drop in the level of cortisol in the evening. An analysis of saliva collected late in the evening, help diagnose Cushing's syndrome;
- Methods of medical imaging. Computed tomography and magnetic resonance imaging can detect a variety of abnormal formation in the pituitary and adrenal glands.
These methods not only to diagnose Cushing's syndrome, but also to eliminate or identify diseases that have similar clinical picture.
Treatment
- Reducing the dose of corticosteroids. If the cause of Cushing's syndrome is the use of corticosteroids, reducing the dose will ease symptoms. In some cases, the doctor may prescribe a drug that is not on corticosteroid. In no case does not limit or stop taking corticosteroids without consulting your doctor.
- Surgery may be imposed if the Cushing's syndrome is caused by a tumor. Removal of a tumor of the pituitary gland holds a neurosurgeon; In many cases, surgery can be done through the nose. To remove tumors of the adrenal glands, lungs or pancreas, standard operations, sometimes with the use of minimally invasive techniques.
- After the operation is assigned to the administration of drugs that replace cortisol to adjust the level of cortisol in the body. In most cases, after some time the body will once again produce cortisol in sufficient quantities. Sometimes this process takes more than this - all this time the patient will need hormone-replacement therapy.
- Radiotherapy. If the surgical method can not completely remove the pituitary tumor, surgery can be assigned to radiotherapy. It is also used when a patient for any reason you can not carry out the operation. The patient can be exposed to low doses for six weeks, or may be used the method of stereotactic radiosurgery. In the latter case, during one procedure the tumor is exposed to a large dose of radiation; effects on the surrounding tissues is minimal.
- Medications. If surgery and radiotherapy are not effective for controlling the level of cortisol can be used medications. They are also used in preparation for surgery in patients with severe forms of Cushing's syndrome. Such drugs as ketoconazole, mitotane and metyrapone, controls the production of cortisol.
Restoration
The duration of the recovery period after the treatment of Cushing's syndrome depends on the severity of the disease and its cause. Patients need to be patient and understand that recovery will not happen overnight.
Return to the previous level of activity should occur slowly but steadily - do not give up loads of muscular weakness, but do not overexert, as this may cause deterioration.
To strengthen bones, patients need to get enough calcium and vitamin D. If you want to take supplements containing these substances.
Monitor your psychological state. Depression is a common consequence of Cushing's syndrome, and a side effect of some of the means used for its treatment. If any signs of depression as soon as possible go to the doctor.
Train your brain. During the recovery after the treatment of Cushing's syndrome, stress play an important role not only the body but also to the brain. Memorizing poems, mathematical problem solving (even the most complex), learning languages can improve brain function and keep it at the proper level.
