Treatment of Cushing Disease

About the disease

Cushing disease, also known as Cushing syndrome, is caused by an excessive amount of cortisol hormone in the human body. Cortisol is a hormone that is produced in the adrenal gland and is responsible for regulating the body’s metabolism. It also helps the person to deal with stress and obstructs substances that cause inflammation. An increased amount of cortisol can cause hypertension (high blood pressure) and can have an adverse affect on the sufferer’s metabolism.

People with Cushing disease usually gain weight, with fatty tissue deposits in the face, abdomen and shoulders. Unless this hormonal disorder is treated quickly, it can cause complications such as diabetes, bone loss and problems with blood pressure. It can also cause increased stress and anxiety attacks. Long-term malnutrition and alcoholism can contribute to the development of Cushing disease. Nonetheless, almost 70% of all cases of Cushing disease are related to corticosteroid drugs, which are prescribed as treatment for inflammatory diseases, such as arthritis. These drugs are also used to prevent the body rejecting a transplanted organ.

Symptoms

• Weight gain
• Changes in the skin, with pink and sometimes purple stretches on different areas of the body
• Fatigue
• Muscle weakness
• Depression
• Headaches
• Bones become more susceptible to fractures
• Skin becomes tender and bruises more easily
• Acne
• Cuts and minor injuries heal slower than usual

Diagnosis

• During a general examination, a doctor will inspect the patient’s skin for signs of redness and tenderness. How much weight the patient has gained will also be determined and the doctor will consider whether there are any other factors that could have caused it.
• A 24-hour cortisol test is usually enough to diagnose Cushing disease. It shows whether the patient has an excessive amount of this hormone in their system.
• CT and MRI scans are sometimes used, to see whether the patient’s bones have been affected by Cushing disease.

Treatment

• Conservative treatment uses special drugs that can decrease the amount of cortisol in the patient’s body. People who have been taking corticosteroid drugs also need to stop taking them immediately and substitute them with other groups of medications.
• If the patient has developed Cushing disease due to a naturally occurring over-production of cortisol, the adrenal or pituitary gland can be surgically removed. The pituitary gland can be removed through the patient’s nose and the adrenal gland through the abdomen. 

The best way to eliminate this disease is to prevent its causes.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko