Define , clinical manifestation , patho, treatment

1. CUSHING SYNDROME

2. • Cushing was a American surgeon
• A condition of over secretion by adrenal cortex due to an adenoma of
the pituitary gland
• Occurs when the body makes too much of the hormone cortisol over
a long period of time
• Cortisol is sometimes called the “stress hormone” as it maintain
blood pressure and regulate blood glucose

3. Cushing Disease:
• Cushing was a American surgeon
• Cushing Disease condition of over
secretion by adrenal cortex due to an
adenoma of the pituitary gland
• Cushing syndrome occurs when the body
makes too much of the hormone cortisol
over a long period of time
• Cortisol is sometimes called the “stress”
hormone” as it maintain blood pressure
and regulate blood glucose

4. • Difference between Cushing disease and Cushing
syndrome?
• Cushing disease is caused by an ACTH-producing pituitary
tumor, whereas
• Cushing syndrome is the set of symptoms that results when
there is a surplus of cortisol
• Causes:
• Pituitary adenoma
• Over activity of CRH,ACTH
• Corticosteroid therapy

5. • Obesity/weight gain
• Abnormal distribution of fat
• Moon-shape face
• Buffalo hump (fat pad on neck)
• Abnormal hair distribution
• Virilism
• Poor wound healing
• Trunk obesity & thin legs
• Muscles weakness
• Mood swings, anxiety, depression,
• Insomnia
Crisis:
• Hypertension
• Hyperglycemia
• hypokalemia

7. Complication
• Osteoporosis; which can result in unusual bone fractures
• High blood pressure (hypertension)
• Type 2 diabetes
• Frequent or unusual infections
• Loss of muscle mass and strength

8. Diagnosis
• Hormones level
• Cortisol /
• ACTH/
• Urine and blood tests.
• To measure cortisol level in blood and urine
• In morning and evening time
• Cortisol levels normally rise early in morning
and falls in evening.
• 24-hrs urine collection:
• to measures free cortisol level in urine
• Saliva test.
• Sample taken in late light, the level of
cortisone will be drop in Cushing syndrome
• Imaging tests. CT or MRI
 Treatment
• Removal of cause
• Reduce Corticosteroid therapy
• Surgery
• Removal of pituitary adenoma
• Medical
• ACTH reducing agents
• Periactin
• somatostatin

10. INCREASED
GLUCOCORTICOID
Insulin
resistance
Protein
catabolism
Abnormal
Distribution of
fat
Persistent
hyperglycemia
Muscle wastage
Weakness,
osteoporosis
Moon-shape face
Buffalos hump
Masculine
changes
androgen
Female /virilism
Male/hirsutism
Mental changes
Low cognitive
function
Sodium
depletion
water retention
Edema,
Hyperkalemia
arrythmias
HYPERGLUCOCORTISOLISM
CUSHING
DISEASE/SYNDROME
INCRESED
ACTH
CUSHING DISEASE/SYNDROME