(Cushing's Disease; Hypercortisolism)
- Long-term use of corticosteroid hormones such as cortisone or prednisone
Excess production of cortisol by:
- Tumor or abnormality of the adrenal gland.
- Tumor or abnormality of the pituitary gland. In the case of a pituitary tumor, it is called Cushing's disease
- Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland.
|Pituitary and Adrenal Glands|
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- Weight gain of the upper body and trunk
- Rounded face
- High blood pressure
- Severe fatigue or muscle weakness
- Easily bruised, thinner skin
- Purple stretch marks
- Excess hair growth or acne in women
- Menstrual disorders, especially infrequent or absent periods
- Diminished fertility and libido
- Personality changes or mood swings
- Psychiatric changes such as depression, anxiety, or psychosis
- 24-hour urinary free cortisol level
- Late-evening cortisol saliva/blood level
- Dexamethasone suppression test
- Blood test for adrenocorticotropin hormone (ACTH) level
- High-dose dexamethasone suppression test
- Rarely, a CRH stimulation test
- Surgical removal of tumor
- Surgical removal of part, all, or both adrenal glands
- Radiation therapy for some persistent tumors
- Gradual withdrawal of cortisone-type drugs under close medical supervision
- Drugs that decrease cortisol production or block the functioning of other adrenal products
American Academy of Family Physicians http://familydoctor.org
Cushing's Support and Research Foundation http://www.CSRF.net
Canadian Family Physician http://www.cfpc.ca
Health Canada http://www.hc-sc.gc.ca
Arnaldi G, Angeli A, Atkinson AB, Bertagna X, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinolo Metabo. 2003;88:5593-5602.
Cushing's Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health/endo/pubs/cushings/cushings.htm. Updated April 6, 2012. Accessed May 1, 2013.
Cushing disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 3, 2013. Accessed May 1, 2013.
Diez JJ, Iglesias P. Pharmacological therapy of Cushing’s syndrome: drugs and indications. Mini Rev Med Chem. 2007;7(5):467-480.
Kirk LF Jr, Hash RB, Katner HP, Jones T. Cushing's disease: clinical manifestations and diagnostic evaluation. Am Fam Physician. 2000;62(5):1119-1127, 1133-1134.
Tritos NA, Biller BM, Swearingen B; Medscape. Management of Cushing disease. Nat Rev Endocrinol. 2011;7(5):279-289.
Makras P, Toloumis G, Papadoglas D, et al. The diagnosis and differential diagnosis of endogenous Cushing’s syndrome. Hormones. 2006;5:231-250.
- Reviewer: Kim Carmichael, MD; Brian Randall, MD
- Review Date: 05/2013 -
- Update Date: 05/01/2013 -