Cushing's syndrome, or hypercortisolism, is a condition that is characterized by a fatty hump between the shoulders (buffalo hump), a rounded face (moon face) and pink or purple stretch marks on the skin.
The condition is caused by long-term exposure to high levels of cortisol, a hormone that reduces inflammation (swelling) in the body. Cortisol, also referred to as hydrocortisone, is naturally produced by the adrenal glands in the body. The steroid hormone, which is an essential component of the body's endocrine system, regulates proper glucose metabolism, blood pressure and insulin release for blood sugar maintenance, and it is involved in the inflammatory response.
Excessive cortisol levels may be caused by factors outside of the body (exogenous) or factors inside the body (endogenous). The syndrome is most often caused by high doses of cortisol-like medication (corticosteroids), which are often prescribed to treat chronic inflammation. Cushing's syndrome may also develop if the adrenal glands make too much cortisol, or if the pituitary gland releases too much adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to release cortisol. When excessive secretions of ACTH cause the condition, it is called Cushing disease. Tumors, either cancerous or benign, cause these glands to produce too many hormones.
Researchers estimate that about 13 million Americans are diagnosed with Cushing's syndrome each year. It is estimated that 10-15 out of one million people are diagnosed with Cushing's syndrome each year worldwide.
Cushing's syndrome can be fatal if left untreated. Severe symptoms may include high blood pressure, bone loss, kidney stones, infections, and sometimes, diabetes. Treatment for Cushing's disease depends on the cause. If the condition is drug-induced, patients are often advised to reduce or discontinue use of the medication. Many conditions that are treated with corticosteroids can also be treated with non-corticosteroid drugs. This allows the patient to either reduce or eliminate the use of corticosteroids altogether. If a tumor is causing the condition, treatment may include surgery and/or radiation therapy. This treatment is typically performed after a diagnosis to prevent the tumor from growing and worsening the patient's condition.
Most patients fully recover from the condition and experience complete remission of symptoms after treatment. However, in some instances, patients with Cushing's syndrome never experience a full recovery to normal adrenal gland function. In such cases, lifelong hormone replacement therapy is necessary to maintain normal levels of cortisol in the body.
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