Cushing’s syndrome

A hormonal disorder caused by an abnormally high level of corticosteroid hormones in the blood. Cushing’s syndrome is characterized by a red moon-shaped face, wasting of the limbs, thickening of the trunk, and a humped upper back. Other symptoms include acne, stretch marks, bruising, weakening of the bones by osteoporosis, susceptibility to infection and peptic ulcers, and, in women, increased hairiness. Mental changes frequently occur, causing depression, insomnia, paranoia, or, euphoria. Hypertension, oedema, and diabetes mellitus may develop. In children, growth may be suppressed. The excess hormones are most commonly due to prolonged treatment with corticosteroid drugs. Such cases of Cushing’s syndrome are usually mild. In other cases, high hormone levels are due to overactivity of the adrenal glands as a result of an adrenal tumour, or of a pituitary tumour affecting production of ACTH (adrenocortocotrophic hormone), which stimulates the adrenal glands. Cushing’s syndrome caused by corticosteroid drugs usually disappears if the dose is gradually reduced. A tumour of an adrenal gland is removed surgically. A pituitary tumour may be removed surgically or shrunk by irradiation and drug treatment. In both cases, surgery is followed by hormone replacement therapy.