Cushing's Disease

Cushing's Disease: A condition in which the pituitary gland secretes to much adrenocorticotropic hormone (ACTH). ACTH stimulates the production and release of cortisol, which is a stress hormone. Cortisol is usually released during stress and it controls the bodies carbohydrates, fats, and proteins. Cortisol also helsps the bodies immune system to reduce swelling. Cushing's Disease can be caused by either a tumor or excess growth of the pituitary gland.

Symptoms: Symptoms of Cushing's Disease include upper body obesity (above the waist) and thin arms and legs, moon face appearance (round and red), slow growth rate in children, acne or skin infections, purple marks on the thighs, abdomen, and breasts, thin skin with easy bruising, backaches, bone pain or tenderness, collection of fat between the shoulders, thinning of bones and weak muscles.

Symptoms that will occur in women: Excess hair growth on the face, neck, chest, abdomen, and thighs and they will also experience irregular or stopped menstrual cycles.

Symptoms that will occur in men: Decreased fertility, decreased or no desire for sex and impotence.

Other symptoms that could occur: Mental changes, fatigue, headaches, high blood pressure, and increased thirst and urination.

Tests: A 24 hour urine cortisol and a Dexamethasone suppression test will confirm that their is to much cortisol being produced.

Treatment: If possible surgery will be performed to remove the pituitary tumor and after surgery the pituitary gland might start to slowly work again and return to normal function. Radiation treatment might also be a consideration. If the tumor does not respond well to the surgery or radiation, medication will be given to stop the body from making cortisol and if this does not work then the adrenal glands might need to be removed to stop high levels of cortisol being produced. If untreated Cushing's Disease can cause severe illness and maybe even death.




MRI images showing a cross-section of the brain through the pituitary gland in a patient with Cushing's disease. The tiny 4 mm microadenoma was detected using a 3-T MRI scanner. A minimally-invasive endoscopic surgical technique was used to remove the entire tumor, curing her of her Cushing's disease. (http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=33&action=detail)