Cushing's disease

Cushing’s syndrome is a severe neuroendocrine disease, manifested by excessive production of ACTH (adrenocorticotropic hormone), caused by the presence of a pituitary tumor or hyperplasia of corticotrophs (ACTH-producing adenohypophysis cells).
ACTH hypersecretion by pituitary adenoma leads to hyperfunction of the adrenal glands. Hypersecretion of hormones of all zones of the adrenal cortex is usually observed (the beam zone – cortisol; the glomerular zone – aldosterone; the reticular zone – dehydroepiandrosterone (adrenal androgen), while in most cases an increase in adrenal gland size is observed.
Females aged 20 through 40 suffer most often.
Sometimes, on the background of adrenal hyperplasia, secondary pituitary adenomas are detected.
Cushing’s syndrome symptoms
The main symptoms of Cushing’s syndrome include:
• dysplastic obesity;
• trophic skin changes;
• hirsutism (male-type overgrowth of terminal hair) in women;
• cardiovascular disorders (arterial hypertension; left ventricular hypertrophy);
• striae;
• systemic osteoporosis;
• secondary hypogonadism;
• secondary immunodeficiency;
• encephalopathy;
• electrolyte and carbohydrate metabolic disorders;
• myopathy;
Differential diagnosis
• Hormone-active tumor of various locations (tumor of the lungs; pancreas, etc.), able to secrete both biologically active ACTH, and its predecessor Corticotropin releasing hormone (corticoliberin) or ACTH-like substances;
• Cushing’s syndrome is characterized by the presence of a tumor of the adrenal cortex (corticosteroma; corticoblastoma);
• Exogenous hypercorticoidism – due to long-term use of corticosteroid drugs;
• Functional hypercortisolism – can be observed in liver diseases, pregnancy, diabetes, hypothalamic syndrome, etc.
Cushing’s syndrome treatment
The method of choice for -Cushing’s syndrome (pituitary adenoma – corticotropic adenoma) is surgical treatment. After surgical treatment, radiation and drug therapy may follow, depending on the pathological structure of the tumor