Hypercortisolism

The most common cause of Cushing syndrome is side effects from taking anti-inflammatory steroid medications for conditions such as asthma and rheumatoid arthritis .

The second most common cause is Cushing's disease, which occurs when the pituitary gland makes too much of the hormone ACTH . ACTH stimulates the adrenal glands to produce cortisol.

Cushing's disease affects women more often than men.

Cushing syndrome can also be caused by the following:

• Tumor of the pituitary gland or adrenal gland
• Tumor elsewhere in the body (ectopic Cushing syndrome)

• Abdomen that sticks out and thin arms and legs (central obesity )
• Acne or skin infections
• Backache
• Collection of fat between the shoulders (buffalo hump )
• Hair growth on the face
• Headache
• Impotence (men)
• Menstrual cycle stops (women)
• Mental changes
• Purple marks on the skin of the abdomen, thighs, and breasts
• Round, red, and full face (moon face )
• Thin skin with easy bruising
• Weakness
• Weight gain (unintentional)

Other symptoms that may occur with this disease:

• Bone pain or tenderness
• Fatigue
• High blood pressure
• Muscle atrophy
• Red spots on the skin
• Skin blushing or flushing

Blood sugar and white blood cell counts may be high. Potassium level may be low.

Laboratory tests are done to confirm high cortisol level . These include:

• Blood test to check cortisol level
• Dexamethasone suppression test
• Urine tests to check cortisol levels

Tests to determine the cause may include:

• Abdominal CT
• ACTH test
• Pituitary MRI

Treatment depends upon the cause.

Cushing syndrome caused by corticosteroid use:

• Slowly decrease the drug dose (if possible) under medical supervision.

Cushing syndrome caused by a pituitary tumor or tumor that releases ACTH:

• Surgery to remove the tumor
• Radiation after removal of a pituitary tumor (in some cases)
• Hydrocortisone (cortisol) replacement therapy (after surgery, and sometimes continued throughout the patient's life)

Cushing syndrome due to an adrenal tumor:

• Surgery to remove the tumor
• If the tumor cannot be removed, medications to help block the release of cortisol

Removing the tumor may lead to full recovery, but there is a chance that the condition will return.

Survival for people with ectopic tumors depends on the tumor type. Untreated, Cushing syndrome can be life-threatening.

• Diabetes
• Enlargement of pituitary tumor
• Fractures due to osteoporosis
• High blood pressure
• Kidney stones
• Serious infections

Call your health care provider if you have symptoms of Cushing syndrome.