Cushing's syndrome, also called hypercortisolism, is a rare endocrine disorder characterised by a variety of symptoms and physical abnormalities. It may be caused by either prolonged exposure of the body's tissues to high levels of the hormone cortisol or by the overproduction of cortisol in the body.
Cortisol is a natural substance produced by the adrenal gland. It can also be produced synthetically.
Exposure to too much cortisol can occur for different reasons.
- Long-term use of glucocorticoid hormones to treat inflammatory illnesses
- Pituitary adenomas (benign tumours of the pituitary glands) which secrete increased amounts of the adrenocorticotropic hormone (ACTH)
- Ectopic ACTH syndrome (a condition in which ACTH is produced by various types of potentially malignant tumours that occur in different parts of the body)
- Adrenal tumours (tumours of the adrenal glands)
Common features of Cushing's syndrome include upper body obesity (lemon-on-sticks appearance), severe fatigue, muscle weakness, high blood pressure, backache, elevated blood sugar, easy bruising and bluish-red stretch marks on the skin. In women, there may be increased growth of facial and body hair. Menstrual periods may become irregular or stop completely.
The prognosis for individuals with Cushing's syndrome varies depending on the cause of overproduction of cortisol. With treatment, most individuals with Cushing's syndrome show significant improvement, while improvement for others may be complicated by various aspects of the causative illness. Some kinds of tumours may recur. Most cases of Cushing's can be cured.
Treatment of Cushing's syndrome depends on the cause of the overproduction of cortisol. If the cause is long-term use of a medication being used to treat another disorder, the doctor may reduce the dosage until symptoms are under control.
Surgery or radiotherapy may be used to treat pituitary adenomas. Surgery, radiotherapy, chemotherapy, immunotherapy or a combination of these may be used to treat ectopic ACTH syndrome.
The aim of treatment is to cure the hypercortisolism and to eliminate any tumour that threatens the individual's health, while minimising the chance of endocrine deficiency or long-term dependence on medications.
Reviewed by Dr H. Neethling