Cushing's syndrome
A hormonal disorder from prolonged glucocorticoid exposure.
Cushing's syndrome is a set of health problems that develop when the body is exposed to high levels of glucocorticoids like cortisol for a long time. The condition was first identified in 1932 by the American neurosurgeon Harvey Cushing. It can be triggered by taking medications that mimic cortisol, such as prednisone, or by a tumor that either makes extra cortisol itself or causes the adrenal glands to produce too much of it.
Common signs include high blood pressure, a round, red face from increased blood flow, and abdominal obesity paired with thin arms and legs. People may develop reddish stretch marks, a fatty hump between the shoulders, weak muscles and bones, acne, and fragile skin that heals slowly. Women might experience excess facial or body hair and irregular periods or a complete loss of menstruation, though the exact reason for this is not known. Mood changes, headaches, and ongoing fatigue can also occur.
When a pituitary adenoma is the cause, the condition is called Cushing's disease, which is the second most common cause overall after medication. Other tumors located outside the pituitary, known as ectopic tumors, can also lead to Cushing's syndrome. Some of these tumors are linked to inherited conditions like multiple endocrine neoplasia type 1 and Carney complex.
Diagnosis involves several steps. First, a person's medications are reviewed. Next, cortisol levels are measured in urine, saliva, or blood after taking dexamethasone. If those results are abnormal, cortisol may be checked late at night. If it remains high, a blood test for ACTH is performed.
Most cases can be treated and cured. If medications are the cause, they can often be slowly reduced or stopped. If a tumor is responsible, treatment may involve surgery, chemotherapy, radiation, or a combination. When the pituitary is affected, additional medications may be needed to replace lost function. With treatment, life expectancy is usually normal, though people whose tumors cannot be fully removed have a higher risk of death.
About two to three people per million develop Cushing's syndrome from an obvious tumor. It most often affects those between 20 and 50 years old, and women are three times more likely than men to be affected. A milder form of cortisol overproduction without clear symptoms is more common. The condition can also occur in other animals, including cats, dogs, and
- field
- Endocrinology
- known_for
- Collection of signs and symptoms due to prolonged glucocorticoid exposure
- first_described_by
- Harvey Cushing
- year_described
- 1932
- affected_population
- 2-3 cases per million persons caused overtly by a tumor
- age_range
- 20 to 50 years of age
- gender_ratio
- Women affected three times more often than men
Lore & Background
Cushing's syndrome presents with signs and symptoms including high blood pressure, abdominal obesity 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. Women may have more hair and irregular menstruation or loss of menses. Occasionally there may be changes in mood, headaches, and a chronic feeling of tiredness. The 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. Cases due to a pituitary adenoma are known as Cushing's disease, which is the second most common cause after medication. A number of other tumors, often referred to as ectopic, may also cause Cushing's, some associated with inherited disorders such as multiple endocrine neoplasia type 1 and Carney complex.
Reader's Guide
Cushing's syndrome is significant as a relatively rare but serious endocrine disorder. Diagnosis requires a stepwise approach: first checking medications, then measuring cortisol levels in urine, saliva, or blood after taking dexamethasone. If abnormal, cortisol may be measured late at night, and if still high, a blood test for ACTH may be done. Most cases can be treated and cured. If caused by medications, these can be slowly decreased or stopped. If caused by a tumor, treatment may involve surgery, chemotherapy, and/or radiation. If the pituitary was affected, other medications may be required to replace its lost function. With treatment, life expectancy is usually normal, though some in whom surgery cannot remove the entire tumor have an increased risk of death. The condition most commonly affects people aged 20 to 50, with women affected three times more often than men. A mild degree of overproduction without obvious symptoms is more common. Cushing's syndrome may also occur in other animals including cats, dogs, and horses.
Did You Know?
- Cushing's syndrome was first described by American neurosurgeon Harvey Cushing in 1932.
- About two to three cases per million persons are caused overtly by a tumor.
- Women are affected three times more often than men.
- Cushing's syndrome may also occur in cats, dogs, and horses.
More in Diseases named after discoverers 1-24
Spotted an error? Know more?
This is a living reference — every entry is fact-audited, and reader corrections feed straight into our audit queue. Suggest an edit · See this site's audit record