What is Cushing's syndrome ?

In Cushing's syndrome, excessive levels of corticosteroids, usually from overproduction of adrenal gland.

* Cushing's syndrome usually results from a tumor that causes the adrenal glands produce excessive corticosteroid.
* People with Cushing's syndrome usually results in excessive fat through the torso and has a great face shape.
Doctors measure the levels of cortisol to identify Cushing's syndrome.
* Surgery or radiation therapy is often needed to remove a tumor.

The adrenal glands can produce excessive kortikosteropid caused problems in the adrenal glands or caused too much stimulation from the pituitary gland. Abnormalities in the pituitary gland, such as a tumor, can cause the pituitary produces large amounts of corticotropin, the hormone that controls the production of corticosteroids from the adrenal glands.

Tumors outside the pituitary gland, such as small cell cancer of the lungs, can produce corticotropin as well (a condition called ectopic corticotropin syndrome). Corticotropin may also be produced by a tumor called a carcinoid, which can occur in almost all parts of the body.

CAUSE
Sometimes a noncancerous tumor (adenoma) occurs in the adrenal glands, which causes the adrenal glands produce excessive corticosteroid. Adrenal adenomas are very common. Half of people experience it at age 70. Only a small part in adenomas produce excess hormones, although such a noncancerous tumor of the adrenal gland are very rare.

Cushing's syndrome can also occur in people who have to use high doses of corticosteroids because of a serious medical condition. Those who must use high doses have the same symptoms as those who produce too much hormone. The symptoms can sometimes occur even if the inhaled corticosteroids, such as for asthma, or used in particular for a skin condition.


SYMPTOMS
Corticosteroids changing the number and distributed into body fat. Body fat is formed through the torso and the real possibility once on the back. A person with Cushing's syndrome usually have a large face (moon face). Hands and feet are usually lean on the shaft is thickened. Muscles lose strength and become weak. The skin becomes thin, easily bruised, heal less well when bruises or injuries. Purple layer that looks like a sign of wrinkles can be formed over the abdomen. People with Cushing's syndrome tend to tire easily.

High levels of corticosteroids every time increases blood pressure, weakening bones (osteoporosis), and reduce perlawana against infection. The risk of developing kidney stones and diabetes is increased, and mental disorders, including depression and hallucinations, can occur. Women usually have an irregular menstrual cycle. Children with Cushing's syndrome grow slowly and remain pandek. In some people, the adrenal glands also produce large amounts of androgens (testosterone and similar hormones), causing an increase in the face and body hair and baldness in women.

Diagnosis

When doctors suspect Cushing's syndrome, they measured levels of cortisol, the main corticosteroid hormone, in blood. Normally, cortisol levels are high in the morning and low at night. In people who have Cushing's syndrome, cortisol levels are very high every day.

If cortisol levels are high, your doctor may recommend dexamethasone suppression test. Dexamethasone suppress pituitary gland and should lead to pressure on the expenditure of cortisol by the adrenal glands. If Cushing's syndrome is caused by too much stimulation of the pituitary, cortisol levels will fall to some extent, although not as much on people who do not have Cushing's syndrome. If you have other causes of Cushing's syndrome, cortisol levels will remain high. High levels of corticotropin further cause overstimulation of the adrenal gland.

Imaging tests may be needed to ensure the exact cause, including a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the pituitary or adrenal glands and a chest X-ray or CT scan of the lungs. Even so, these tests can sometimes fail to find the tumor. When overproduction of corticotropin stated as the cause, the possibility of blood samples taken from veins that drain the pituitary to see if that is the source.


TREATMENT
Treatment depends on whether the adrenal gland problems, pituitary gland, or other areas. Surgery or radiation therapy may be needed to remove or destroy the pituitary tumor. Tumors of the adrenal gland (usually adenomas) can often be removed surgically. Both adrenal glands can be removed if these treatments are not effective or if there is no tumor.

People who both adrenal glands removed, and many people who have part in the adrenal glands removed, should be using corticosteroids for life. Tumors outside the pituitary and adrenal glands that secrete too much hormone is usually removed surgically. Certain drugs, such as metyrapone or ketoconazole, may reduce levels of cortisol and can be used while awaiting more definitive treatment such as surgery.