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Cushing’s disease is an endocrine disorder and occurs as a consequence of Cushing’s syndrome. In this condition, a small part of the pituitary gland is producing too much adrenocorticotropic hormone (ACTH), which further results in elevated cortisol level. Majority of the incidents are caused by pituitary gland tumor or prolonged use of corticosteroid medication. Cushing’s disease occurs more often in women than man, representing 4,5 to 1 ratio. The most common symptoms include weight gain, high blood pressure, fatigue, rounded face and irritability. Usually, surgery is done in order to eliminate the tumor, and this method has high success rate. However, when untreated, it can lead to serious consequences, including death.
Cushing’s disease characteristics
This condition distinguish itself by too high production of adrenocorticotropic hormone (ACTH). Afterwards, this high level of ACTH stimulates production and emission of cortisol in excessive quantities. Cortisol is regulating several important processes, and its inadequate level leads to cardiovascular or immune systems disorders. It can disturb metabolism and insulin levels as well.
What is more, the disease is more prevalent in females, resulting in 4,5:1 women-men ratio, and most of them are affected during their 50s. Cushing’s disease might also be fatal when untreated, especially due to cardiovascular disorders. Overall death rate is believed to be around 10% of total incidents.
Causes of Cushing’s disease
The most common causes include either prolonged use of corticosteroids or pituitary gland tumor (adenoma). Corticosteroids are often prescribed in order to relieve severe pain and inflammatory diseases or to stabilize the process of transplanted organ assimilation. Their intake is often higher than usual organism’s daily demands. When used for a long period of time and with high dosage it might result in Cushing’s disease. Apart from this, the condition might be caused due to pituitary gland tumor, also called as adenoma, which is responsible for approximately 80% of endogenous (originating internally) incidents. This type of tumor is usually noncancerous (benign). It needs to be noted, that adenoma tendency can be determined by genetic background, thus family history may increase the risk of developing Cushing’s disease.
Symptoms and signs
Symptoms and signs may vary, depending on the disease progress or levels of ACTH, and they can be divided into 2 categories.
Popular symptoms, occurring in most of the incidents, include:
- Weight gain
- High blood pressure (hypertension)
- Rounded face (moon face)
Rare symptoms include:
- Muscle weakness
Diagnosis and treatment
This type of disease is fairly difficult to recognize, because there is no unique sign or symptom. Diagnosis might be based on physical examination and several medical tests, like urinalysis, blood test or saliva test. In addition, imaging may be done in order to detect tumor inside pituitary gland. Recent corticosteroid medication therapy may be another clue for a healthcare provider.
Treatment method usually include surgery or radiation therapy, which are done in order to remove the tumor. However, drugs are recommended if the disease is not caused by the tumor. Medications may reduce production of ACTH, cortisol or both of them. If the patient is on any corticosteroid medications, the doctor can advise dosage reduction.
Without medical treatment, Cushing’s disease can lead to osteoporosis (bones weakening), diabetes, chronic hypertension, kidney stones and increased infection tendency.