Cushing's SyndromeMedical Author:
George P Chrousos, MD, FAAP, MACP, MACE
Coauthor:
Shehnaz Shaikh, MD
Medical Editor:
Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS
Medical Editor:
Mary L Windle, PharmD
Medical Editor:
George T Griffing, MD
Cushing's Syndrome OverviewCushing's syndrome is a disorder caused by prolonged exposure of the body's tissues to high levels of corticosteroids (glucocorticoids). Corticosteroids are powerful steroid hormones produced by the adrenal glands, located above each kidney. They regulate the metabolism of proteins, carbohydrates, and fats. They reduce the immune system's inflammatory responses and help to maintain blood pressure and heart function. A vital function of corticosteroids is to help the body respond to stress. Corticosteroid production by the adrenal glands follows a sequence of events. The hypothalamus (see Anatomy of the Endocrine System) releases corticotropin-releasing hormone (CRH), which causes the pituitary gland to secrete adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to produce corticosteroid. When the corticosteroid level is low, more CRH and ACTH are produced; when the corticosteroid level is high, less CRH and ACTH are produced. Under normal conditions, the corticosteroid level and CRH/ACTH levels are in dynamic balance; Cushing's disease occurs when that balance is disturbed. Excess corticosteroids have detrimental effects on many of the tissues and organs of the body. All of these effects together are called Cushing's syndrome. Overproduction of corticosteroids can be caused by a tumor in the pituitary gland, which produces excess ACTH, thereby stimulating the adrenal gland to produce excess corticosteroids. This condition is called Cushing's disease because the origin is in the hypothalamic pituitary system. Cushing's syndrome is a q collection of symptoms which look and act like Cushing's disease but is not the result of pituitary ACTH overproduction. Endogenous Cushing's syndrome is the result of autonomous, unregulated production of corticosteroids by a tumor within one or both of the adrenal glands themselves. The most common cause of Cushing's syndrome, however, is exogenous Cushing's syndrome, which results from taking excessive amounts of corticosteroid drugs. The majority of cases of Cushing's syndrome are caused by administration of corticosteroids (exogenous) for the treatment of long-term diseases such as asthma, arthritis, and lupus. |
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Cushing Syndrome
Topic Overview
What is Cushing's syndrome?
Cushing's syndrome is a rare hormonal problem. It happens when there is too much of the hormone cortisol in your body.
Normally, cortisol levels increase through a chain reaction of hormones:
- First, the hypothalamus in the brain makes a hormone called CRH (corticotropin-releasing hormone).
- Then, CRH tells the pituitary gland to make another hormone called ACTH (adrenocorticotropic hormone).
- ACTH then tells the adrenal glands to make cortisol. Cortisol affects almost every area of the body. It is especially important in regulating blood pressure and metabolism.
But if your body makes too much cortisol—or if you take certain medicines that act like cortisol—you may start to have symptoms. Cushing's syndrome may cause weight gain, skin changes, and fatigue. It can lead to serious problems, such as diabetes, high blood pressure, depression, and osteoporosis. If not treated, it ca...
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Cushing Syndrome »
Cushing syndrome is caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids.
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