OverviewCushing's syndrome - a collection of symptoms that occur during long-term effects on the body of excess glucocorticoids. Glucocorticoids - a hormone that normally stand out adrenal glands. These include cortisol and corticosterone. Glucocorticoids regulate virtually all types of metabolism, and many physiological functions. The activities of the adrenal glands is controlled by the anterior pituitary release of adrenocorticotropic hormone (ACTH). The higher levels of ACTH, the more cortisol and corticosterone synthesized. In turn, the pituitary gland is controlled by the hypothalamus through the release of hormones called liberiny and statins. This multi-step mechanism of regulation is necessary for the harmonious functioning of the organism and the maintenance of metabolism. Violation of each of the links may lead to overproduction of glucocorticoids by the adrenal cortex, causing Cushing's syndrome.
The causes of the disease- Pituitary tumor (adenoma), causing hyperproduction of ACTH;
- Ectopic secretion of ACTH and CRH did not pituitary tumors (oat cell cancer, pancreatic cancer, bronchial adenoma);
- Adrenal hyperplasia;
- Adenoma or cancer of the adrenal glands;
- Long-term treatment with drugs containing corticosteroids or ACTH (exogenous Cushing's syndrome).
Symptoms of Cushing's syndromePeople with Cushing's syndrome have a characteristic appearance: the typical marked obesity with excess deposition of fat on the face (moon face), neck, chest and abdomen, and limbs due to muscle atrophy and decrease in volume looks thin, the skin becomes thinner, it is easy to form bruises, there are bands stretch marks (striae). The last two symptoms are caused by disruption of the structure of connective tissue. In areas of friction in the area of the collar on the neck, abdomen, elbows arises enhanced coloring of the skin.
Patients concerned about high blood pressure and associated headaches. Increasing muscle atrophy leads to severe muscle weakness. Violation of mineral metabolism leading to osteoporosis, a tendency to frequent fractures. In children, growth retardation observed. In Cushing's syndrome, impaired formation of sex hormones in women is manifested hirsutism (hair growth in male type), and menstrual irregularities and male signs of feminization.
Diagnosis of Cushing's syndromeThe purpose of diagnosis is not only and not evidence of Cushing's syndrome as determining the cause of this condition. For this purpose, as a rule requires holding a series of tests and investigations:
- Determination of cortisol in the urine and blood plasma, determination of ACTH concentration in plasma;
- Diagnostic tests to determine the localization of pathology are samples from dexamethasone, CRH and ACTH;
- MRI for the detection of pituitary adenoma;
- CT or MRI of the abdominal cavity to detect tumors of the adrenal glands.
TreatmentDiagnosis and treatment of Cushing's syndrome carries an endocrinologist.
Treatment depends on the cause of the disease.