Cushing's Syndrome

Cushing’s syndrome is due to overproduction of the hormone cortisol, which is a steroid hormone. This leads to widespread effects in the body, which may include high blood pressure, diabetes, bone fractures, menstrual irregularities in women, and weight gain.

Three forms of Cushing’s disease are recognised:

  1. Due to a benign tumour of the pituitary gland. First line treatment for this is an operation on the pituitary gland. If this fails to control the Cushing’s disease then an operation to remove both adrenal glands (which are the ultimate source of the cortisol production) may be indicated. This should usually be performed using a minimally invasive (laparoscopic) approach.
  2. Due to a benign or malignant (cancerous) tumour of one of the adrenal glands. Surgical removal of the affected adrenal gland, usually using a minimally invasive (laparoscopic) approach is the treatment of choice in this situation.
  3. Due to production of cortisol by organs other than the pituitary or adrenal glands. The commonest reason for this is a lung cancer. Treatment should be directed to the source of the hormone overproduction.

Specialised blood and urine tests are needed to diagnose Cushing’s disease, and to differentiate between the three causes listed above. CT or MRI scans can then be used to localise where in the body the cause for the Cushing’s disease is located.

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