Adrenal Gland Disorder - Cushing's Syndrome

Cushing's Syndrome

Description

Cushing’s syndrome is the result of the excessive production of corticosteroids by the adrenal glands. An overproduction of corticotrophin, the hormone that controls the adrenal gland by the pituitary gland, which stimulates the adrenal glands to produce the corticosteroids, could be of one cause. It also can be in excessive cortisol levels in the blood which may be the result of a tumor of the pituitary glands, adrenal glands or from tumors or cancer arising elsewhere in the body. Cushing’s disease refers to specifically to excessive ACTH secretion by a pituitary tumor. The cause of Cushing’s syndrome is a pituitary adenoma in over 70% of adults and approximately 60-70% of children and adolescents. Cushing’s disease is relatively rare, affecting ten to fifteen in every million people each year and most commonly affected adults between the ages of 20 to 50 years. Women however, account for over 70% of the case.

Symptoms

The symptoms and signs of Cushing’s syndrome are: change in body habitus; weight gain in the face, above the collar bone and on the back of the neck, skin changes with easy bruising, excess hair growth on the face, neck, chest, abdomen, and thigh, generalized weakness and fatigue, loss of muscles, menstrual disorders in women, decreased fertility and/or sex drive, high blood pressure, and high blood sugar. These symptoms are brief descriptions of what can be found in patients with Cushing’s disease and each individual may experience symptoms differently.

Causes

People can develop Cushing's syndrome by taking glucocorticoids or their body is exposed to high levels of cortisol. Glucocorticoids are steroid hormones that are chemically similar to the cortisol produced by our bodies. Someone can also develop chushings syndrome if their body produces too much cortisol naturally. Cortisol is used for many important tasks in the body. It helps to maintain blood pressure and cardiovascular function. It breaks down glucose for energy by balancing the effects of insulin. Its main purpose is to help the body with stress. Depression, alcoholism, malnutrition, and panic disorders all increase levels of cortisol. This increases the chances of getting Cushing's syndrome.

Treatments

Treatment of Cushing’s syndrome can vary depends on the cause of cortisol excess. People with Pituitary Adenomas can treated with several kinds of treatments. Most preferably is to use a surgical method called transphenoidal adenomectomy. The surgeon uses a microscope and other instrument to get to the gland. In order to get to the gland they would either have to make an opening below the upper lip of the patient or they would have to go through the nostril. The success rate for this type of treatment is above 80 percent and can be performed more than once if necessary. The level of ACTH within the patient should temporary drop about 2 levels below normal. The patient would also be given a synthetic cortisol such as hydrocortisone. The end results usually are less than a year for the treatment to take effect. For people who do not qualify for transphenoidal adenometomy or if the treatment didn’t work, they could use radiotherapy to treat the disease. By using radiation to treat the gland for 6 weeks, about 40 percent to 50 percent of adults and a possible 80 percent of children improved. They also use a drug called Miotane to decrease plasma or urine hormone levels. Other drugs such as aminoglutethimide, metyrapone, trilostane and ketoconazole can be use as a replacement for Miotane or to be use along with Miotane. It is up to the doctor’s discretion because each one of these drugs has its own side effects.

People who have an Adrenal tumor as a result of Cushing syndromes can use a procedure called laparoscopic adrenalectomy. It is only use for Adrenal tumors that are less than 6 cm. This treatment is strongly recommended because the patient can recover much quicker and experience less pain than other open procedures.

Ectopic ACTH syndrome can be cured by destroying all ACTH cancer tissue. Depends on the type of cancers, surgery, chemotherapy, radiotherapy, immunotherapy, or combination of these treatment can be used to cure the disease.