QS Study

Definition

The clinical condition caused by hyperfunction of the adrenal cortex is called Cushing syndrome. It occurs due to abnormally high levels of the hormone cortisol. It occurs more commonly in female than male. The situation can also happen when your body makes too much cortisol on its own.

Cause

(A) ACTH dependent cause: In these diseases, the body is making too much ACTH which leads to too much cortisol production.

  • Bilaterlater adrenocortical hyperplasia due to increased pituitary ACTH secretion.
  • Ectopic ACTH syndrome is due to secretion of ACTH by a benign or malignant tumor of other organs.
  • Latrogenic.

(B) Non-ACTH dependent cause: This is usually caused by an adrenal tumor but can be caused by bilateral adrenal hyperplasia as well.

  • Adenomas or carcinoma of the adrenal cortex,
  • Latrogenic pharmacological doses of corticosteroid.
  • Latrogenic.

Clinical feature: Patients who have Cushing’s syndrome have too much cortisol or steroid in their blood. Cushing’s syndrome can be caused by either taking too many steroids as a medication or if the body makes too much steroid.

  • Moon face (Deposition of fat in the face)
  • Buffalo neck (Deposition of fat in the subscapular region)
  • Pendulous abdomen,
  • Wasting and weakness of proximal thigh muscle,
  • Osteoporosis,
  • Atherosclerosis,
  • Hypertension,
  • In male – Excessive hair growth; In female amenorrhoea,
  • Pigmentation of the body,
  • In male – impotence, and finale – amenorrhoea,
  • Reddish purple abdominal striae,
  • Hyperglycemia,
  • Poor wound healing.

Treatment –

  1. Surgical removal or destroy by radiation of hyperthyroid pituitary gland.
  2. Surgical removal of an adrenal tumor.
  3. Decrease secretion of ACTH – If it is possible.