Information on Cushing's Disease

Cushing's disease is characterized by chronic high levels of circulating glucocorticoids, resulting from the presence of a pituitary adenoma. The disease is expressed from the tumor's release of ACTH (adrenocorticotropin) hormone into the blood. This pituitary gland tumor, which is usually benign, causes the production of corticosteroids by the adrenal gland, from the release of the ACTH hormone.

Identification

• The tumors that invade the pituitary gland are very small and often undetectable, except through blood or imaging tests to diagnose Cushing's disease. Microadenomas are suspected when high levels of ACTH is found in the blood.

Symptoms

• The symptoms of Cushing's disease include upper body obesity, sensitive and thinning skin, fat, round face, fatigue, muscle weakness, osteoporosis, irregular menstruation, hypertension, bacterial infections, high blood sugar levels and wounds that take long to heal. Cushing's disease can lead to sterility in men and women. It causes excess hair growth, including on the face, thighs, chest and neck of women.

Diabetes

• Diabetes mellitus can occur in patients with Cushing's disease. The ACTH hormone inhibits the function of insulin, causing hyperglycemia. Therefore, high levels of sugar are left to circulate in the blood. Its resulting effects on the psychological state of the person include depression, anxiety and panic.

Diagnosis

• The process of diagnosing Cushing's disease starts with a physical exam of the patient's condition. If it is discovered that the expression of Cushing's disease is iatrogenic--caused by another medication--no further testing is necessary.
  In the absence of medications causing the disease, the doctor would then order blood and urine tests, with the urine being collected over 24 hours. The doctor may also use a steroid, dexamethasone, to gauge how well the body responds and processes it.
  Further testing may include a CT scan or an MRI to find the exact locations of any existing tumors.

Treatment

• Treatment for Cushing's disease involves the surgical removal of the pituitary gland adenoma. Radiation is sometimes used afterward to stunt or prevent any future tumor growth. Patients may also be given steroids as they heal from the surgery. It is important to treat Cushing's disease to prevent further damage to the internal organs--especially the heart--and to preserve the quality of life of the patient.