A disease characterized by an excess of cortisol, which is the hormone produced in the adrenal glands under stress or when blood glucocorticoid levels drop. Cortisol raises blood glucose levels, aids in the metabolism of fats, proteins and carbohydrates, and decreases the immune system response.
The most frequent cause is chronic use of glucocorticoid drugs (prednisone, dexamethasone and prednisolone), which mimic the action of cortisol. It can also be associated with pituitary, adrenal and other tumors.
People with this disorder have a round, red face, accumulate fat in the trunk and lose it in the arms, legs and buttocks (central obesity), have excess hair, decreased lividity and impotence. In childhood it causes slow growth and in women it can cause irregular menstruation.
Diagnosis is clinical by questioning and physical examination. Blood tests will confirm the diagnosis and other tests may be necessary to determine the origin.
Treatment is aimed at correcting the cause. If the origin is pharmacological, treatment should be slowly withdrawn. If the cause is a tumor, treatment will usually be surgical.
- Lynnette K Nieman. Causes and pathophysiology of Cushing's syndrome. UpToDate. May 27, 2014.
- Lynnette K Nieman. Epidemiology and clinical manifestations of Cushing's syndrome. UpToDate. Jul 13, 2015.
- Lynnette K Nieman. Establishing the diagnosis of Cushing's syndrome. UpToDate. Jun19, 2015.
- Lynnette K Nieman. Establishing the cause of Cushing's syndrome. UpTODate. Nov 26, 2013.
- Arlt W. Trastornos de la corteza suprarrenal. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 2313-2318.
- Malmed S. Jameson L. Síndromes de tumores adenohipofisarios. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 2271-2273
