Cushing’s syndrome is the collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol.[3][8][9] Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly.[2] Women may have more hair and irregular menstruation.[2] Occasionally there may be changes in mood, headaches, and a chronic feeling of tiredness.[2]
Cushing’s syndrome is caused by either excessive cortisol-like medication such as prednisone or a tumor that either produces or results in the production of excessive cortisol by the adrenal glands.[10] Cases due to a pituitary adenoma are known as Cushing’s disease, which is the second most common cause of Cushing’s syndrome after medication.[3] A number of other tumors may also cause Cushing’s.[3][11] Some of these are associated with inherited disorders such as multiple endocrine neoplasia type 1 and Carney complex.[7] Diagnosis requires a number of steps.[4] The first step is to check the medications a person takes.[4] The second step is to measure levels of cortisol in the urine, saliva or in the blood after taking dexamethasone.[4] If this test is abnormal, the cortisol may be measured late at night.[4] If the cortisol remains high, a blood test for ACTH may be done.[4]
Most cases can be treated and cured.[6] If due to medications, these can often be slowly decreased if still required or slowly stopped.[5][12] If caused by a tumor, it may be treated by a combination of surgery, chemotherapy, and/or radiation.[5] If the pituitary was affected, other medications may be required to replace its lost function.[5] With treatment, life expectancy is usually normal.[6] Some, in whom surgery is unable to remove the entire tumor, have an increased risk of death.[13]
