Programs and Disease Treatment
Cushing’s syndrome occurs when the body is exposed to too much of the hormone cortisol. It is a serious and unusual hormonal disorder, so patient care is best provided by hormonal disorders specialists (endocrinologists) highly experienced in diagnosing and treating Cushing’s syndrome. Since the 1970s, endocrinologists at The Medical College of Wisconsin have been pioneering approaches now commonly used across the country. In fact, Medical College of Wisconsin endocrinologist James Findling, MD, was instrumental in developing two of the most widely used tests in the nation for Cushing’s, the salivary cortisol test and inferior petrosal sinus sampling (IPSS).
Symptoms of Cushing’s SyndromeAt proper levels, cortisol helps the body respond to stress, regulate important functions in the body and convert fat, carbohydrates and proteins into energy. Too much cortisol can lead to Cushing’s syndrome, causing symptoms including:
- Weight gain in the neck, face and upper body
- Flushing in the face
- Easy bruising
- Purple stretch marks on the stomach
- High blood pressure
- Bone loss/osteoporosis with fractures
- Excess facial hair and fewer menstrual periods in women
- Muscle weakness
- Significant problems with memory and thinking
Causes of Cushing’s SyndromeThe most common cause of Cushing’s syndrome is cortisol-like steroid medications, such as prednisone. These medications may be prescribed at a high dose for a long period of time to treat lupus, asthma and other conditions. Genetically, some patients are more sensitive to cortisol-like steroids than others.
Tumors or nodules in or near the pituitary and adrenal glands may also be the cause. These conditions include:
- Cushing’s disease. Cushing’s disease is associated with non-cancerous and usually small pituitary gland tumors that secrete adrenocorticotropic hormone (ACTH). Too much ACTH enlarges the adrenal glands and causes them to over produce cortisol.
- Ectopic ACTH syndrome. This condition is associated with cancerous or noncancerous tumors that develop outside the pituitary gland, most often in the lungs, and produce excess ACTH.
- Cortisol-producing adrenal tumors. Small, non-cancerous adrenal tumors (adrenal nodules) can also produce too much cortisol. Symptoms are mild, so they may be overlooked for many years.
Diagnosing Cushing’s SyndromeTo diagnose this complex condition, physicians use tests including:
If a Cushing’s syndrome diagnosis is confirmed by these tests, other tests may be conducted to pinpoint the cause and determine the most appropriate treatment for Cushing’s syndrome. Magnetic resonance imaging (MRI) may be recommended to scan for ACTH-secreting tumors that cause Cushing’s, most of which are found in the pituitary. If the MRI is inconclusive, additional tests may be requested, including:
Last Review Date: May 7, 2013
Online Editor(s): Shannon Krause