Cushing's disease

Cushing's disease refers to a condition characterized by an overproduction of the hormone cortisol by the adrenal glands, usually caused by a pituitary gland tumor. This hormonal imbalance can result in a variety of health issues, from physical changes to psychological disturbances.

Straie with cushing syndrome new photo

Overview

Cushing's disease is a subtype of Cushing's syndrome, a condition characterized by an excess of cortisol, a hormone that plays a crucial role in numerous bodily functions. The term "Cushing's disease" is specifically used when the excess cortisol is caused by a pituitary adenoma.

Symptoms and Clinical Presentation

Common symptoms of Cushing's disease include weight gain, particularly around the abdomen and face, skin changes such as purple stretch marks and easy bruising, muscle weakness, mood changes, and, in women, irregular menstruation.

Pathophysiology

In most cases of Cushing's disease, a tumor in the pituitary gland, known as a pituitary adenoma, produces an excess of adrenocorticotropic hormone (ACTH). This, in turn, stimulates the adrenal glands to produce more cortisol than the body needs.

Diagnosis

Diagnosing Cushing's disease can be challenging due to the variability of symptoms and their overlap with other conditions. It often involves blood and urine tests to measure cortisol levels, as well as imaging tests such as MRI to identify potential tumors. A definitive diagnosis usually requires a combination of clinical findings and laboratory testing.

Treatment

The primary treatment for Cushing's disease is surgery to remove the pituitary tumor. This is typically done through a procedure known as transsphenoidal surgery, where the surgeon accesses the pituitary gland via the nose and sinuses. In cases where surgery is not possible or does not fully remove the tumor, additional treatments such as radiation therapy or medication may be used.

Prognosis

The prognosis for individuals with Cushing's disease varies depending on the severity of the disease and the success of treatment. If the tumor can be fully removed, there is a good chance of recovery, although it may take time for the body to return to normal cortisol production. In cases where the tumor cannot be fully removed, or if it returns, further treatment may be necessary and the prognosis can be less favorable.

Epidemiology

Cushing's disease is relatively rare, with an estimated prevalence of 2 to 3 cases per million people per year. It most commonly affects adults between the ages of 20 and 50 and is more common in women than men.

See Also

• Cushing's syndrome
• Pituitary adenoma
• Adrenal gland
• Cortisol

References

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