Definition

Cushing syndrome is too much of a hormone called cortisol in the blood. In normal doses, this hormone helps the body manage stress and infection. High levels over a long period of time can cause health problems.

Causes

High levels of this hormone may be caused by:

• Long-term use of corticosteroid hormones, such as cortisone or prednisone
• Excess production of cortisol from a:
  • Tumor or abnormality of the adrenal gland
  • Tumor or abnormality of the pituitary gland. A person with a pituitary tumor has Cushing disease.
  • Tumors of the lung, thyroid, kidney, pancreas, or thymus gland (rare)

Pituitary and Adrenal Glands

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Risk Factors

This problem is more common in people who use corticosteroids to treat problems, such as:

• Lupus
• Rheumatoid arthritis

Symptoms

Problems may be:

• Weight gain in the upper body and trunk
• Rounded face
• Severe fatigue or muscle weakness
• Easily bruised, thin skin
• Purple stretch marks
• Excess hair growth or acne in women
• Menstrual problems, especially irregular or absent periods
• Low fertility and interest in sex
• Personality changes or mood swings

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests, urine tests, and saliva tests to check a person's levels of cortisol.

Images may be taken to look at the pituitary and adrenal glands and at other internal structures. This may be done with:

• MRI scan
• CT scan
• Chest x-ray
• Bone density test

Treatment

Treatment of Cushing syndrome depends on the cause. Options are:

• Stopping or changing corticosteroids
• Surgical removal of a tumor
• Surgical removal of part, all, or both adrenal glands
• Radiation therapy to treat lasting tumors
• Drugs that decrease the amount of cortisol the body makes or block the way other adrenal products work

Prevention

The risk of this problem may be lowered by limiting long-term corticosteroid use.