Hypercortisolism - Disease - Saglik Lokman

Glossary of diseases

Hypercortisolism

Medical name (Cushing's syndrome)

Possible Symptoms

Increased thirst Impairment of male potency Menstruation disorder Wound Muscular weakness in the arm Muscular weakness in the leg Muscle pain Pain in the bones Muscular atrophy of the arm Muscular atrophy in the leg Weight gain Headache Difficulty to concentrate Bone fracture Anxiety Visual field loss Muscle weakness

Short description

Hypercortisolism or cushing’s syndrome is a disturbance in hormonal balance that can have different causes. It is a group of symptoms triggered by extremely high levels of a hormone named cortisol in the body. The disease happens when the body is producing too much cortisol or is exposed to high levels of cortisol for a long time. Hypercortisolism can also be caused by the use of oral corticosteroid medication. Patients with cushing's syndrome have a very typical appearance.

Description

Chronically elevated glucocorticoids (from various causes) lead to Cushing's syndrome. A distinction is made in terms of the cause, which can be the administration of glucocorticoids (called iatrogenic Cushing’s syndrome) for the treatment of another disease, elevated glucocorticoids due to benign or malignant tumors of the adrenal glands (peripheral Cushing's syndrome), or an adenoma (benign tumor) of the pituitary gland (central Cushing's syndrome).

Occurrence and Symptoms

Patients with cushing's syndrome show a typical appearance with trunk accented obesity (waist and abdomen are thick, legs and arms rather thin), moon face, buffalo hump, facial redness and acne. The skin is so thin that superficial small blood vessels are visible and stretch marks (striae rubra) can happen. The patients often complain of weakness (climbing stairs for example), apathy, and bone pain. In women, it also often leads to menstrual irregularities and virilization of the hair. All the symptoms depend on the amount and duration of the excess of glucocorticoids.

Consequences and Treatment

In case of a central cushing’s syndrome, the treatment of choice is removal of the pituitary adenoma through the nose. For small adenomas, the cure rate is 90%, for gig adenomas 50 %. As a peripheral cushing's syndrome is almost always caused by tumors of the adrenal glands, the surgical removal of the affected adrenal gland is displayed with very good cure rates. After surgery, glucocorticoids may have to be taken as a tablet, usually for a limited period, until the remaining adrenal gland has assumed the function of the removed gland. The treatment of iatrogenic Cushing's syndrome is a cessation of glucocorticoid therapy (or at least a reduction in the dose, a termination is often not possible). It is essential to ensure that the drug is tapered slowly and must not be discontinued abruptly.

Where could I go?

Endocrinology Internal medicine Pediatrics

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