A condition in which there is an excess of cortisol, the hormone produced by the adrenal glands in response to stress or when glucocorticoid hormone levels in the blood fall. Cortisol raises blood glucose levels, aids the metabolism of fats, proteins and carbohydrates, and lowers the immune system response.
It is most commonly caused by long-term use of glucocorticoids (prednisone, dexamethasone and prednisolone), which mimic the effects of cortisol. It can also be associated with tumours of the pituitary gland, adrenal glands and others.
People with this condition have a red, round face, an accumulation of fat in the torso with a decrease in the arms, legs and buttocks (central obesity), excess hair, reduced libido and impotence. It is a cause of slow growth in children and irregular menstruation in women.
It is diagnosed clinically by interview and physical examination. Blood tests are used to confirm the diagnosis and other tests may be needed to determine the cause.
Treatment aims to correct the cause. If the cause is pharmacological, the treatment will be tapered off. If the cause is a tumour, treatment is usually 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.
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