Cushings Syndrome

Definition Cushing’s Syndrome is a disorder involving the hormones and is particularly caused by an abnormal increase in the amount of the hormone cortisol or other glucocorticoid hormones in the blood (Nieman et al., 2008). In the case of an overactive immune system, glucocorticoids usually turn down the inflammation system as a sort of negative feedback mechanism. However, if there is too much production of glucocorticoids, especially cortisol, in the blood, then the entire immune system might be turned down, thus leading to a variety of numerous physiological disturbances known as Cushing’s syndrome (Nieman et al., 2008). Causes The main cause of Cushing’s syndrome is the overproduction of the adrenocorticotropic hormone, or ACTH, by the pituitary gland, which is usually known as Cushing’s Disease. Another cause is an adrenal gland tumor that usually occurs among women over 40 years of age. A third cause is a tumor somewhere in the body which either produces too much cortisol or causes its production, such as tumors in the pancreas, lungs or thyroid that oversecrete ACTH (Nieman et al., 2008).The overproduction of ACTH by the pituitary gland causes the production of excessive cortisol by the adrenal glands. An alternative initial step would be an excess of corticotrophin-releasing hormone, or CRH, from the hypothalamus causing the pituitary gland to produce excessive ACTH (Nieman et al., 2008). However, the most initial step for Cushing’s syndrome is the ACTH stimulating the adrenal glands for the production of cortisol (Blevins, 2002). Symptoms Cushing’s Syndrome is characterized by reddish-purple striae, plethora, proximal muscle weakness, bruising with no obvious trauma, as well as unexplained osteoporosis (Nieman et al., 2008). Other symptoms of the disease include obesity, depression, diabetes, hypertension, or menstrual irregularity (Nieman et al., 2008). If Cushing’s Syndrome affects the higher brain centers in the case of complications, it may cause anxiety disorder, obsessive-compulsive disorder, depression, alcoholism and diabetes. Other more noticeable symptoms include obesity of the upper torso coupled with disproportionately thin limbs, a round and red face with characterized fullness, and acne or certain other skin infections. The less common symptoms include a buffalo hump, backache, tenderness and pain of the bones, rib and spine fractures, weak muscles, excessive hair growth in the woman, impotence and lack of sexual desire in men, and certain headache, tiredness and feelings of thirst and hunger (Nieman et al., 2008). Treatment The treatment of choice is surgical removal of the tumor. This should be followed by treatment with hydrocortisone or hydrocortisone replacement therapy because cortisol levels will go down fast once the tumor is removed. Moreover, in the case of patients with malignant adrenal cortical neoplasm, the treatment of choice must be open adrenalectomy (Thomson et al., 2010). Through an MRI scan, cases of mediastinal masses that intertwine with the heart nerves must be done with extreme care so as not to injure such a delicate organ.