2. Cushing's Disease/ Cushing's Syndrome:
Cushing's is a hormonal disorder caused by prolonged
exposure of the body's tissues to high levels of the
hormone cortisol. Your adrenal glands, which are right
above your kidneys, release cortisol when they receive a
chemical message from your pituitary gland. The message
comes in the form of adrenocorticotrophic hormone
(ACTH), which travels through the bloodstream.
The pituitary gland is known as the “Master gland of the
body”.
Introduction
4. Definition
It is a condition in which the plasma cortisol
level is elevated, causing signs and symptoms
of Hypercortisolism.
5. Causes of Cushing’s
⚫A benign tumorof theadrenal gland
⚫A benign tumorof the pituitary gland
⚫A benign tumorof the lung orotherorgan
⚫Extensive use of cortisone medication
⚫Administration of ACTH or Corticosteroids.
⚫Primary hyperplasia of both adrenal gland.
⚫Excessive secretion of adrenal androgen.
⚫Exogenous Glucocorticoid administration.
7. Pathophysiology:
Due to etiological factor
Normal feedback mechanisms that control adreno cortical
function are ineffective.
Resulting in excess secretion of adrenal cortical hormones
Inadequate amount of adrenal cortical hormones in
secretion
Hypercortisolism
10. Medical Management
⚫Mitotane = An agent toxicto theadrenal cortex.
⚫Metropine = Tocontrol (steroid hypersecretion) who
do not respond to mitotanetherapy.
⚫Amino-glutethimide = Effectively Blocking cortisol
production
⚫Protein anabollicsteroids may begiven to facilitate is
required (proteinand potassium replacement)
11. Surgical Mgt:
i) Trans sphenoidal adenomectomyor Hypophysectomy:
= Removal of pituitarygland
ii) Transfrontal Carinotomy:
= It is necessarywhen pituitary tumor is enlarge.
iii) Bilateral Adrenalectomy:
= Hyperplasiaof adrenals
