Cushing's Syndrome



Cushing's Syndrome is a rare endocrine disorder.


In simple words, Cushing's Syndrome means an excess of cortisol in the body, which gives rise to a variety of signs and symptoms.


Signs and Symptoms of Cushing's Syndrome


Signs and symptoms of Cushing's Syndrome include:




Causes of Cushing's Syndrome


The most common cause of Cushing's Syndrome is steroids use.


Other causes are:




Diagnostic Evaluation of Cushing's Syndrome


A constellation of the above-mentioned clinical signs and symptoms in a patient on steroids is enough to make a diagnosis of Cushing' Syndrome.


If there is no history of steroid use, then further diagnostic work-up is needed, which includes:


24-hour urine for free cortisol.

Overnight 1 mg Dexamethasone Suppressionjn test.

 Midnight salivary cortisol.


Once a diagnosis of high cortisol level is made, next step is to find out the source of excess cortisol: pituitary vs adrenal.


This involves quite complex testing and should be carried out by an experienced endocrinologist.


Treatment of Cushing's Syndrome



Treatment obviously depends upon the cause:If it is a pituitary, adrenal or any other tumor, then surgical removal of the tumor, if possible is the logical choice of treatment.


If steroid use is the cause of Cushing's Syndrome, then steroids should be slowly tapered under the supervision of an endocrinologist. Because chronic steroid use causes a suppression of your own adrenal gland.If you were to suddenly stop your steroids, you will likely develop acute adrenal insufficiency which can be life-threatening.











This article was written by Sarfraz Zaidi, MD, FACE. Dr. Zaidi specializes in Diabetes, photoEndocrinology and Metabolism.


Dr. Zaidi is a former assistant Clinical Professor of Medicine at UCLA and Director of the Jamila Diabetes and Endocrine Medical Center in Thousand Oaks, California.





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