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Cushing's Disease in Childhood

Cushing's disease, or Cushing's syndrome, is rare in children, with only one or two children out of a million diagnosed a year, according to the Cushing's Research and Support Foundation. Cushing's disease is a result of too much cortisol being released into the body from the adrenal glands. Cortisol is necessary for proper metabolic function and to help the body respond to stress adequately.

  1. Causes

    • Cushing's disease can occur from corticosteroid injections given for bursitis, or joint or back pain. Since children normally do not receive corticosteroid injections or medications, the most likely cause of Cushing's disease in children may be that their own bodies are overproducing cortisol. The overproduction may be related to a noncancerous tumor on the pituitary gland or from adrenal gland disease.

    Symptoms

    • Symptoms of Cushing's disease may be different in each child, but the main symptoms for children are weight gain, a decrease in height growth and an increase in blood pressure. Other symptoms may include a rounded face, headaches, irritability, thin skin, purplish marks on skin that may appear as bruising, fatigue, high blood sugar and thinning arms and legs.

    Diagnosis

    • Your doctor may perform tests or refer you to a specialist such as a pediatric endocrinologist. The doctor may want you to provide photos of your child before the symptoms began so he can compare them with how the child looks now. He will review your child's medical history and compare prior weight and height.

    Tests

    • Your doctor may ask you to provide her with your child's urine samples over a 24-hour period. The samples are tested for cortisol levels. If high levels are shown, other tests are required to find the reason. An MRI or CT scan is taken to see if the adrenal or the pituitary gland is enlarged, or if a tumor is attached to the glands.

    Treatment

    • Treatment depends on the cause of the high cortisol levels. If a tumor is the cause, surgical removal of the tumor should correct the cortisol levels. Removal of both or one adrenal gland normally requires a hormone-replacement supplement for the remainder of the child's life. Recovery time after surgery ranges from two weeks to two months. During this time, the body is readjusting to its new cortisol level and your child may suffer from memory or concentration difficulties. Provide emotional support during this time.

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