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    TOP

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 Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

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

• Lupus
• Rheumatoid arthritis

Symptoms    TOP

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    TOP

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    TOP

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    TOP

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