Encyclopedia

Cushing’s syndrome

Cushing’s syndrome is a disease caused by prolonged exposure of body tissues to high levels of corticosteroids /glucocorticoids/.

Corticosteroids are powerful steroid hormones secreted by the adrenal glands, which are located above each of the kidneys. They regulate the exchange of proteins, carbohydrates and fats in the body.

Reduce inflammatory reactions of the immune system and help maintain blood pressure and heart function. The main function of corticosteroids is to provide the body’s response to stress.

The secretion of corticosteroids by the adrenal glands is an element of an overall process.

The hypothalamus releases corticotropin-releasing hormone, which stimulates the pituitary gland to secrete adrenocorticotropic hormone, which in turn stimulates the adrenal glands to release corticosteroid.

When corticosteroid levels are low, then the levels of the other two hormones are higher and vice versa. Under normal conditions, the levels of corticosteroids and the other two hormones are in dynamic equilibrium.
Cushing’s disease develops when this balance is disturbed.

What are the symptoms?

• Weight gain, especially in the face, around the neck, upper back and generally throughout the torso.
• Changes in the skin such as purple-colored stretch marks, easy bruising, and other signs of skin thinning.
• Proximal muscle weakness causing difficulty in climbing on stairs and getting up from a low chair.
Psychological problems such as depression, cognitive dysfunction and emotional lability;
• Additional increase in blood pressure with hypertension and rising levels of blood sugar in diabetics.
• Decreased bone mass and frequent occurrence of fractures due to weakened bones /steroid-induced osteoporosis/;
Polyuria or polypsidia /increased thirst/ from diabetes mellitus or diabetes insipidus.
Slowed wound healing or predisposition to frequent infections due to impaired immune system function.
• < strong>Irregular menstruation, amenorrhea and hirsutism /excessive hair growth/ in women.
• Decreased libido, infertility and impotence in men.
• In people in whom abnormal adrenocorticotropic hormone levels are due to a tumor in the pituitary gland, may develop headache, polyuria and nocturia, visual problems or galactorrhea – the woman’s breasts secrete breast milk, even though she has not given birth recently.

What are the causes?

Exogenous administration of corticosteroids, i.e. external application of the hormone;
• Endogenous oversecretion of adrenal hormones;
• < strong>Adrenal tumor – the oversecretion of corticosteroids may be due to an adrenal tumor, which may be benign or malignant.
Pituitary tumors, increasing the secretion of adrenocorticotropic hormone – tumor formations indirectly stimulate the adrenal glands to release increased amounts of corticosteroids. order stimulates the release of larger amounts of hormones from the adrenal glands.

Treatment of Cushing’s syndrome

The method of treatment is determined depending on the underlying cause of the syndrome. The goal of treatment is to restore the dynamic balance of the three hormones, which will also balance the levels of corticosteroids.

Treatment may consist of surgical tumor removal, radiation therapy or the use of corticosteroid-inhibiting drugs.

If the cause of the syndrome is the long-term use of corticosteroids to treat another disease, for example asthma or gastritis, your doctor will gradually reduce the dose to the lowest possible to control this disease.< /p>

Drugs that inhibit corticosteroid synthesis such as mitotane, ketoconazole, metyrapone, aminoglutemide, trilostane, and etomidate are rarely used because they are toxic at the doses required to reduce corticosteroid secretion.< /p>

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