Cushing's syndrome: Wikis

  

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.Cushing's syndrome (also called hyperadrenocorticism or hypercorticism) is a hormone (endocrine) disorder caused by high levels of cortisol (hypercortisolism) in the blood.^ Cushing syndrome can also be caused by the following: .
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ Treatments for Cushing's syndrome are designed to lower the high level of cortisol in your body.
  • Cushing's Syndrome - Definition, Causes, Symptoms and Treatment 16 September 2009 22:23 UTC www.articlesbase.com [Source type: Academic]

^ Cushing's syndrome Primary adrenal causes of Cushing\'s syndrome.
  • WikiGenes - Cushing Syndrome 18 September 2009 5:35 UTC www.wikigenes.org [Source type: Academic]

.This can be caused by taking glucocorticoid drugs, or by tumors that produce cortisol or adrenocorticotropic hormone (ACTH).^ The tumor itself is not the problem, but it causes the body to produce too much of the hormone cortisol.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ A pituitary tumor often causes too little ACTH to be produced.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Nonfunctioning pituitary tumors Nonfunctioning tumors do not produce hormones .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

[1] .Cushing's disease refers to one specific cause, a tumor (adenoma) in the pituitary gland that produces large amounts of ACTH, which in turn elevates cortisol.^ When a pituitary tumor secretes excessive ACTH, the disorder resulting from this specific form of Cushing's syndrome is referred to as Cushing's disease.
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

^ Pituitary Adenoma : Pituitary adenomas cause most cases of Cushing's syndrome .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Treatment of Cushing's disease caused by pituitary tumors is symptomatic therapy -- it does not cure the pituitary tumor.
  • Cushing's Disease in Dogs - What is it, and how do we treat it? 12 October 2009 10:50 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

.It can usually be cured by surgery.^ It can usually be cured by surgery.
  • About: Cushing's syndrome 19 January 2010 18:38 UTC dbpedia.org [Source type: Academic]

.Cushing's syndrome is not confined to humans and is also a relatively common condition in domestic dogs and horses.^ Pergolide treatment for Cushing's syndrome in a horse.
  • Cushings Disease 12 October 2009 10:50 UTC www.horse101.com [Source type: FILTERED WITH BAYES]
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

^ Hyperadrenocorticism, also known as Cushing's syndrome, is a common endocrine disorder in dogs.
  • cushings 22 September 2009 15:015 UTC www.gsdhelp.info [Source type: FILTERED WITH BAYES]

^ Cushing's Syndrome treatment in horses .
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

It was described by American Dr. Harvey Cushing in 1932.[2]

Contents

Classification and etiology

.There are several possible causes of Cushing's syndrome.^ Can stress cause Cushing's syndrome?
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

^ Cushing's syndrome Primary adrenal causes of Cushing\'s syndrome.
  • WikiGenes - Cushing Syndrome 18 September 2009 5:35 UTC www.wikigenes.org [Source type: Academic]

^ It is the cause of 70% of spontaneous Cushing's syndrome.
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

Exogenous vs. endogenous

.Hormones that come from outside the body are called exogenous; hormones that come from within the body are called endogenous.^ The small organ called pituitary adenoma helps make hormones for the growth of the body.
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ The adrenal cortex produces cortisol , a hormone that regulates nearly every type of organ and tissue within the body.
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ It occurs when the body's tissues have been exposed for an extended period to too much of a hormone called cortisol.
  • June 21, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.The most common is exogenous administration of glucocorticoids prescribed by a health care practitioner to treat other diseases (called iatrogenic Cushing's syndrome).^ Cushing's Disease in Dogs - What is it, and how do we treat it?
  • Cushing's Disease in Dogs - What is it, and how do we treat it? 12 October 2009 10:50 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ Exogenous Cushing syndrome is a form of Cushing syndrome that occurs in people taking glucocorticoid (also called cor...
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ This form of the syndrome is known as Cushing's disease.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.This can be an effect of steroid treatment of a variety of disorders such as asthma and rheumatoid arthritis, or in immunosuppression after an organ transplant.^ Many people suffer the symptoms of Cushing's syndrome because they take steroids such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ Many people suffer the symptoms of Cushing's syndrome because they take glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation.
  • Cushing's Syndrome - Definition, Causes, Symptoms and Treatment 16 September 2009 22:23 UTC www.articlesbase.com [Source type: Academic]

^ This "iatrogenic" (caused by the treatment) form is unfortunately a necessary side effect when high doses of these steroid hormones must be used to treat certain life-threatening illnesses, such as asthma, rheumatoid arthritis, systemic lupus, inflammatory bowel disease, some allergies, and others.
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

.Administration of synthetic ACTH is also possible, but ACTH is less often prescribed due to cost and lesser utility.^ But Fedela was carefully watching what she ate, often eating less than her doctors prescribed.
  • December 6, 2006 Cushing's Help and Support/Newsletters 16 September 2009 22:23 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.Endogenous Cushing's syndrome results from some derangement of the body's own system of secreting cortisol.^ Cushing syndrome Cortisol secretion in Nelson syndrome: Persistence after \"total\" adrenalectomy for Cushing syndrome.
  • WikiGenes - Cushing Syndrome 18 September 2009 5:35 UTC www.wikigenes.org [Source type: Academic]

^ Others develop Cushing's syndrome because of overproduction of cortisol by the body.
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

^ Increased production of any or all of these hormones may result in a variety of disorders, such as Cushing's syndrome and hypertension.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Normally, ACTH is released from the pituitary gland when necessary to stimulate the release of cortisol from the adrenal glands.^ It goes to the pituitary gland and stimulates it to release a hormone called adrenocorticotrophic hormone (aCTH).
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ ACTH is an acronym for adrenalcorticotrophic hormone and it stimulates the cortex of the adrenal gland to manufacture and release cortisol (cortisone).

^ ACTH stimulates the adrenal glands to produce cortisol.
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

.
  • In pituitary Cushing's, a benign pituitary adenoma secretes ACTH. This is also known as Cushing's disease and is responsible for 65% of endogenous Cushing's syndrome.
  • In adrenal Cushing's, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia.
  • Finally, tumors outside the normal pituitary-adrenal system can produce ACTH that affects the adrenal glands.^ Rarely, micronodular or macronodular ACTH-independent adrenal hyperplasia can be the cause of Cushing's syndrome.
    • Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - September 1, 2000 - American Family Physician 22 September 2009 15:015 UTC www.aafp.org [Source type: Academic]

    ^ When a pituitary tumor secretes excessive ACTH, the disorder resulting from this specific form of Cushing's syndrome is referred to as Cushing's disease.
    • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

    ^ Pituitary Adenoma : Pituitary adenomas cause most cases of Cushing's syndrome .
    • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

    This final etiology is called ectopic or paraneoplastic Cushing's syndrome and is seen in diseases like small cell lung cancer.

Signs and symptoms

In humans

.Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity).^ I'm depressed and anxious Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity), a round face often referred to as a "moon face, <...> Depression and anxiety are also common.

^ Symptoms include weight gain, central obesity, moon face, weakness, fatigue, backache, headache, increased thirst, increased urination, impotence, mental status changes, and muscle atrophy.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Symptoms may include headaches, problems with balance and walking, dizziness, weakness of the limbs, vision problems, and high blood pressure.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.A common sign is the growth of fat pads along the collar bone and on the back of the neck (buffalo hump) and a round face often referred to as a "moon face". Other symptoms include hyperhidrosis (excess sweating), telangiectasia (dilation of capillaries), thinning of the skin (which causes easy bruising and dryness, particularly the hands) and other mucous membranes, purple or red striae (the weight gain in Cushing's syndrome stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders), and hirsutism (facial male-pattern hair growth), baldness and/or cause hair to become extremely dry and brittle.^ Symptoms vary, but most people have upper body obesity (central obesity), rounded face ("moon face"), increased fat around the neck and on the back of the neck ( buffalo hump ), and thinning arms and legs.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ Other occasional symptoms include: .
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ The most common symptom is sudden weight gain.
  • Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - September 1, 2000 - American Family Physician 22 September 2009 15:015 UTC www.aafp.org [Source type: Academic]

.In rare cases, Cushing's can cause hypercalcemia, which can lead to skin necrosis.^ Rarely, micronodular or macronodular ACTH-independent adrenal hyperplasia can be the cause of Cushing's syndrome.
  • Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - September 1, 2000 - American Family Physician 22 September 2009 15:015 UTC www.aafp.org [Source type: Academic]

^ Cushing’s disease is caused by a rare tumor in the pituitary gland.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ The growth of a tumor on one of the two Adrenal glands causes about 15% of all cases of Cushing syndrome....
  • Adrenal glands and hair loss - Healthcare.com 18 September 2009 5:35 UTC www.healthcare.com [Source type: FILTERED WITH BAYES]

.The excess cortisol may also affect other endocrine systems and cause, for example, insomnia, inhibited aromatase, reduced libido, impotence, amenorrhoea/oligomenorrhea and infertility due to elevations in androgens.^ The excess cortisol may also affect other endocrine systems and cause, for example, reduced libido, impotence and infertility.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ This excess cortisol is monitored by the hypothalamus and pituitary in the negative feedback mechanism, causing them to secrete less ACTH. Less ACTH in the bloodstream will cause the other adrenal (if it does not also have a tumor) to atrophy (shrink).
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ Pneumonia and other infections due to the effects of excess cortisol on the immune system are advanced signs.
  • Equine Cushings Disease 12 October 2009 10:50 UTC www.farriervet.com [Source type: FILTERED WITH BAYES]

.Patients frequently suffer various psychological disturbances, ranging from euphoria to psychosis.^ Patients frequently suffer various psychological disturbances, ranging from euphoria to frank psychosis.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

.Depression and anxiety are also common.^ Irritability, anxiety and depression are common.

^ Depression and anxiety, including panic attacks, are common.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

[3]
.Other striking and distressing skin changes that may appear in Cushing's syndrome include facial acne, susceptibility to superficial dermatophyte and malassezia infections, and the characteristic purplish, atrophic striae on the abdomen.^ She was diagnosed with Cushing's Syndrome in May, 1998.
  • Cushing's Disease/Syndrome | Electronic Forum Digest 42 22 September 2009 15:015 UTC www.io.com [Source type: General]

^ The face may become round and “moon-like,” there may be a thinning and weakness of the muscles of the upper arms and/or legs and the skin may appear thin and bruise easily.
  • December 6, 2006 Cushing's Help and Support/Newsletters 16 September 2009 22:23 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ Purplish pink stretch marks ( striae ) may appear on the abdomen, thighs, buttocks, arms and breasts.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

[4]:500
.Other signs include polyuria (and accompanying polydipsia), persistent hypertension (due to cortisol's enhancement of epinephrine's vasoconstrictive effect) and insulin resistance (especially common in ectopic ACTH production), leading to hyperglycemia (high blood sugar) which can lead to diabetes mellitus.^ High blood pressure (hypertension) is common in dogs with hyperadrenocorticism.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ Her blood sugar runs high at times.
  • Cushing's Disease/Syndrome | Electronic Forum Digest 42 22 September 2009 15:015 UTC www.io.com [Source type: General]

^ Most people have severe fatigue, weak muscles, persistent hypertension (due to the aldosterone-like effects) and insulin resistance , leading to hyperglycemia (high blood sugars) which can lead to diabetes mellitus.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

.Untreated Cushing's syndrome can lead to heart disease and increased mortality.^ Untreated, Cushing syndrome can be life-threatening.
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ This form of the syndrome is known as Cushing's disease.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ What is the difference between Cushing's Syndrome and Cushing's Disease?
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

.Cushing's syndrome due to excess ACTH may also result in hyperpigmentation, such as acanthosis nigricans in the axilla.^ Cushing syndrome due to adrenal tumor .
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ Excess ACTH may also result in hyperpigmentation of the skin.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ She was diagnosed with Cushing's Syndrome in May, 1998.
  • Cushing's Disease/Syndrome | Electronic Forum Digest 42 22 September 2009 15:015 UTC www.io.com [Source type: General]

.This is due to Melanocyte-Stimulating Hormone production as a byproduct of ACTH synthesis from Pro-opiomelanocortin (POMC).^ It goes to the pituitary gland and stimulates it to release a hormone called adrenocorticotrophic hormone (aCTH).
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ Pituitary diabetes insipidus : Metabolic disorder due to injury of the pituitary gland causing a deficient production of anti-diuretic hormone .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ These adenomas also secrete melanocyte-stimulating hormone, resulting in characteristic hyperpigmentation of the skin.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Cortisol can also exhibit mineralcorticoid activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion).^ It is the amount of aCTH circulating in the blood stream that tells the adrenal glands (specifically, the cells at the zona fasciculata) how much cortisol to secrete.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ ACTH/cortisol secretion is increased due to stress, including infection, pain, surgery, trauma, cold temperatures.
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

^ High blood pressure (hypertension) is common in dogs with hyperadrenocorticism.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

.Furthermore, gastrointestinal disturbances, opportunistic infections and impaired wound healing (cortisol is a stress hormone, so it depresses the immune and inflammatory responses).^ Cortisol is produced by the adrenal glands and helps the body respond to stress, such as surgery and illness, and recover from infections.
  • Cushing's Syndrome - Signs and Symptoms 16 September 2009 22:23 UTC www.ucsfhealth.org [Source type: Academic]

^ Cortisol is released into the bloodstream at times of stress to prepare the body for a flight or fight response, and therefore the level of concentration of the hormone fluctuates depending on the situation.

^ In addition, immune and inflammatory cells have their responses to stress attenuated by cortisol, and the hormone thus lowers the activity of the immune system.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Osteoporosis is also an issue in Cushing's syndrome since, as mentioned before, cortisol evokes a stress-like response.^ Can stress cause Cushing's syndrome?
  • http://www.cushings-info.com/ourfaqs/cushings_1.html 22 September 2009 15:015 UTC www.cushings-info.com [Source type: Academic]

^ J. Med.  (1985) Gastric inhibitory polypeptide-dependent cortisol hypersecretion--a new cause of Cushing's syndrome.
  • WikiGenes - Cushing Syndrome 18 September 2009 5:35 UTC www.wikigenes.org [Source type: Academic]

^ In addition, immune and inflammatory cells have their responses to stress attenuated by cortisol, and the hormone thus lowers the activity of the immune system.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Consequently, the body's maintenance of bone (and other tissues) becomes secondary to maintenance of the false stress response.^ Cortisol normally regulates the body’s response to stress.
  • December 6, 2006 Cushing's Help and Support/Newsletters 16 September 2009 22:23 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ Basically, what happens with people who have hypercortisolemia is that they have the inability to shut off the stress response so they are constantly responding to stress differently than other people.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ But like the adrenaline also secreted by the adrenal glands, cortisol production increases with the body's "fight or flight" response to stressful situations, whether physical or emotional.
  • June 21, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.Additionally, Cushing's may cause sore and aching joints, particularly in the hip, shoulders, and lower back.^ Our vet feels that it is the Cushing's causing this limping, and that swimming therapy may help.
  • Cushing's Disease in Dogs - What is it, and how do we treat it? 12 October 2009 10:50 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ Ultrasonagraphy isn’t a very good initial test for Cushing’s disease because the changes may not be pronounced in the case of PDH and any tumor visualized may or may not be causing Cushing’s disease.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ I guess my questions are this: can Cushings cause such severe muscle loss in one particular area of an animal, and is there a way I can help her get some muscle back?
  • Cushing's Disease in Dogs - What is it, and how do we treat it? 12 October 2009 10:50 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

Diagnosis

.When Cushing's syndrome is suspected, either a dexamethasone suppression test (administration of dexamethasone and frequent determination of cortisol and ACTH level), or a 24-hour urinary measurement for cortisol offer equal detection rates.^ The test showed a baseline cortisol level of 3.7, followed by readings > of 1.0 at 4 hours and 1.1 at 8 hours.
  • Cushing's Disease/Syndrome | Electronic Forum Digest 42 22 September 2009 15:015 UTC www.io.com [Source type: General]

^ In this test an injection of Dexamethasone is given and cortisol levels are measured at 4 hours and 8 hours after the injection.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ If a larger than expected, rise in cortisol levels is measured in 2 hours we may diagnose Cushing’s syndrome.
  • cushings 22 September 2009 15:015 UTC www.gsdhelp.info [Source type: FILTERED WITH BAYES]

[5] .Dexamethasone is a glucocorticoid and simulates the effects of cortisol, including negative feedback on the pituitary gland.^ Cushing's disease specifically refers to a tumor in the pituitary gland that stimulates excessive release of cortisol from the adrenal glands by releasing large amounts of ACTH. In Cushing's syndrome , ACTH levels will normally drop due to negative feedback from the high levels of cortisol.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ Using high doses of dexamethasone it is possible to fairly reliably suppress any effect of the pituitary gland on adrenal gland production of cortisols.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ This excess cortisol is monitored by the hypothalamus and pituitary in the negative feedback mechanism, causing them to secrete less ACTH. Less ACTH in the bloodstream will cause the other adrenal (if it does not also have a tumor) to atrophy (shrink).
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

.When dexamethasone is administered and a blood sample is tested, high cortisol would be indicative of Cushing's syndrome because there is an ectopic source of cortisol or ACTH (eg: adrenal adenoma) that is not inhibited by the dexamethasone.^ This condition is known as Ectopic ACTH Syndrome .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Cushing's syndrome is an endocrine disorder caused by high levels of cortisol in the blood from a variety of causes.
  • Cushing's Syndrome - OrganizedWisdom Health 19 January 2010 18:38 UTC organizedwisdom.com [Source type: General]

^ For Cushing's syndrome caused by adrenal tumors .
  • Cushing's Syndrome - Treatment Overview - Yahoo! Health 12 October 2009 10:50 UTC health.yahoo.com [Source type: General]

.A novel approach, recently cleared by the US FDA, is sampling cortisol in saliva over 24 hours, which may be equally sensitive, as late night levels of salivary cortisol are high in Cushingoid patients.^ High cortisol levels may continue.
  • Ectopic Cushing Syndrome - Symptoms, Diagnosis, Treatment of Ectopic Cushing Syndrome - NY Times Health Information 18 September 2009 5:35 UTC health.nytimes.com [Source type: News]

^ The first is the sampling of serum cortisol over a 24-hour period.
  • OHSUpituitary.com - Cushing's Disease 22 September 2009 15:015 UTC www.ohsupituitary.com [Source type: FILTERED WITH BAYES]

^ A high level of cortisol in the sample is suggestive of Cushing's.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

.Other pituitary hormone levels may need to be ascertained.^ Some of them lacked growth hormone because they had birth defects, tumors or other diseases that cause the pituitary gland to malfunction or shut down.
  • 911! Adrenal Crisis / Cushings-Help.com Support for Addison's Disease and Adrenal Insufficiency 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Original source]

^ Gonadotropin Releasing Hormone (GnRH): The "master hormone" in the reproductive system, since it signals the pituitary gland to release two other hormones crucial in ovulation - FSH and LH .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Prolactin TSH ( thyroid stimulating hormone ) FSH ( Follicle stimulating hormone ) LH ( luteinizing hormone ) ACTH ( adrenocorticotropic hormone ) ADH ( antidiuretic hormone ) Other pituitary gland disorders.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Performing a physical examination to determine any visual field defect may be necessary if a pituitary lesion is suspected, which may compress the optic chiasm causing typical bitemporal hemianopia.^ More uncommonly, it may be caused by a pituitary gland disorder.
  • 911! Adrenal Crisis / Cushings-Help.com Support for Addison's Disease and Adrenal Insufficiency 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Original source]

^ These classic laboratory findings complement the physical examination and may lead your veterinarian to recommend definitive testing for Cushing’s Syndrome.
  • cushings 22 September 2009 15:015 UTC www.gsdhelp.info [Source type: FILTERED WITH BAYES]

^ Diagnosis is based on typical clinical signs as described above, laboratory abnormalities, and adrenal function tests which will help your veterinarian to determine if the disease is caused by abnormal pituitary stimulation of the adrenal glands, or by an adrenal tumour.
  • cushings 22 September 2009 15:015 UTC www.gsdhelp.info [Source type: FILTERED WITH BAYES]

.When any of these tests are positive, CT scanning of the adrenal gland and MRI of the pituitary gland are performed to detect the presence of any adrenal or pituitary adenomas or incidentalomas (the incidental discovery of harmless lesions).^ These tests evaluate the interactions that are occurring between the hypothalamus, the pituitary gland, and the adrenal gland.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ Alternatively, MRI or CT scans may show pituitary gland tumors but this is not a very sensitive test.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ It is possible to identify pituitary tumors with MRI or CT scans.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

.Scintigraphy of the adrenal gland with iodocholesterol scan is occasionally necessary.^ Adrenal gland scans .
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ When too much adrenaline or noradrenaline is produced from the adrenal gland, a tumor is suspected and therefore, an adrenal gland scan is required.
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ Since some adrenal gland function is necessary for survival, it is necessary to try to balance the amount of destruction that occurs against the need for cortisone in the body.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

.Very rarely, determining the cortisol levels in various veins in the body by venous catheterization, working towards the pituitary (petrosal sinus sampling) is necessary.^ This allows the body to precisely refine the level of cortisol, and to change the level rapidly due to changing physiologic needs.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ By measuring this cortisol with a blood sample we can determine what reserve the adrenal glands have in the production of cortisol.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ Dogs with pituitary dependent hyperadrenocorticism tend to have two very large adrenal glands, as both are constantly working to keep up production of excess cortisol.
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

Pathophysiology

.The hypothalamus is in the brain and the pituitary gland sits just below it.^ The pituitary gland is located just below the brain (the adrenal glands are located just above each kidney).
  • December 6, 2006 Cushing's Help and Support/Newsletters 16 September 2009 22:23 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ The pituitary gland, located at the base of the brain, produces ACTH (adrenocorticotrophic hormone), as directed by the hypothalamus (another part of the brain).
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

^ It is a form of Cushing’s syndrome caused by a tumor on the pituitary gland, found at the base of the brain, that secretes excess levels of the ACTH hormone.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.The paraventricular nucleus (PVN) of the hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to release adrenocorticotropin (ACTH).^ The process commences when the hypothalamus produces corticotrophin hormones which stimulate the pituitary gland.
  • Treatment to Help Relax Overactive Adrenal Glands in Cats and Dogs 12 October 2009 10:50 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

^ Under normal circumstances cortisol production is balanced by the hormone CRH corticotropin releasing hormone from the hypothalamus which stimulates ACTH adrenocorticotropic hormone from the pituitary.
  • Cushings Disease 12 October 2009 10:50 UTC www.horse101.com [Source type: FILTERED WITH BAYES]
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

^ Cortisol also inhibits the secretion of corticotropin releasing hormone (CRH), resulting in feedback inhibition of ACTH secretion.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.ACTH travels via the blood to the adrenal gland, where it stimulates the release of cortisol.^ ACTH stimulates the adrenal glands to produce cortisol.
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ Normally, cortisol is released from the adrenal glands in response to ACTH being released from the pituitary gland.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ When a dog or cat is given ACTH by an injection the adrenal glands are stimulated to produce cortisol.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

.Cortisol is secreted by the cortex of the adrenal gland from a region called the zona fasciculata in response to ACTH. Elevated levels of cortisol exert negative feedback on the pituitary, which decreases the amount of ACTH released from the pituitary gland.^ When stimulated by ACTH, the adrenal gland secretes cortisol and other steroid hormones.
  • Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - September 1, 2000 - American Family Physician 22 September 2009 15:015 UTC www.aafp.org [Source type: Academic]

^ Cortisol also inhibits the secretion of corticotropin releasing hormone (CRH), resulting in feedback inhibition of ACTH secretion.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ The pituitary adenoma secretes increased amounts of adrenocorticotropin (ACTH), which causes another set of glands, the adrenal glands, to release excess levels of cortisol into the blood.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

.Strictly, Cushing's syndrome refers to excess cortisol of any etiology.^ The treatment for Cushing's syndrome depends on the specific cause of the cortisol excess.
  • Cushings syndrome 1 18 September 2009 5:35 UTC www.ulm.edu [Source type: Academic]

^ Treatment of Cushing’s syndrome can vary depends on the cause of cortisol excess.
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ Cushing's disease specifically refers to a tumor in the pituitary gland that stimulates excessive release of cortisol from the adrenal glands by releasing large amounts of ACTH. In Cushing's syndrome , ACTH levels will normally drop due to negative feedback from the high levels of cortisol.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

.One of the causes of Cushing's syndrome is a cortisol secreting adenoma in the cortex of the adrenal gland.^ Cushing syndrome can also be caused by the following: .
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ The treatment for Cushing's syndrome depends on the specific cause of the cortisol excess.
  • Cushings syndrome 1 18 September 2009 5:35 UTC www.ulm.edu [Source type: Academic]

^ What causes Cushing's syndrome?
  • Cushing's Syndrome - Topic Overview - Yahoo! Health 18 September 2009 5:35 UTC health.yahoo.com [Source type: FILTERED WITH BAYES]

.The adenoma causes cortisol levels in the blood to be very high, and negative feedback on the pituitary from the high cortisol levels causes ACTH levels to be very low.^ Cushing's syndrome is an endocrine disorder caused by high levels of cortisol in the blood from a variety of causes.
  • Cushing's Syndrome - OrganizedWisdom Health 19 January 2010 18:38 UTC organizedwisdom.com [Source type: General]

^ Blood levels of cortisol naturally vary ...
  • iTriageHealth.com: Cushing disease (Excessive cortisol disease) 19 January 2010 18:38 UTC www.itriagehealth.com [Source type: Academic]

^ The cortisol level is low.
  • 911! Adrenal Crisis / Cushings-Help.com Support for Addison's Disease and Adrenal Insufficiency 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Original source]

.Cushing's disease refers only to hypercortisolism secondary to excess production of ACTH from a corticotrophic pituitary adenoma.^ With Cushing's disease the ACTH production of the pituitary adenoma will usually not get suppressed thus suggesting a pituitary cause for the Cushing's disease.
  • Cushing's disease and Cushing's syndrome - WebHealth 19 January 2010 18:38 UTC webhealth.com [Source type: Academic]

^ Cushing’s disease refers to specifically to excessive ACTH secretion by a pituitary tumor.
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ Cushing's disease is a form of Cushing's syndrome that is caused by an ACTH secreting pituitary adenoma.
  • OHSUpituitary.com - Cushing's Disease 22 September 2009 15:015 UTC www.ohsupituitary.com [Source type: FILTERED WITH BAYES]

.This causes the blood ACTH levels to be elevated along with cortisol from the adrenal gland.^ ACTH stimulates the adrenal glands to produce cortisol.
  • AllRefer Health - Cushing's Syndrome (Hypercortisolism) 18 September 2009 5:35 UTC health.allrefer.com [Source type: Academic]
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ It can also be caused by a tumor in the adrenal gland .
  • ClownsFun @ Dikkedeur.dyndns.org - ClownsFun @ Dikkedeur.dyndns.org 19 January 2010 18:38 UTC dikkedeur.dyndns.org [Source type: Academic]

^ Then, ACTH stimulates the adrenal glands to produce cortisol.
  • Cushing's Syndrome - Topic Overview - Yahoo! Health 18 September 2009 5:35 UTC health.yahoo.com [Source type: FILTERED WITH BAYES]

.The ACTH levels remain high because a tumor causes the pituitary to be unresponsive to negative feedback from high cortisol levels.^ Serum cortisol, serum ACTH levels, and urinary 5-HIAA remain normal.
  • A Case of Cushing Syndrome Secondary to Ectopic Adrenocorticotropic Hormone Producing Carcinoid of the Duodenum - Health News - redOrbit 18 September 2009 5:35 UTC www.redorbit.com [Source type: Academic]

^ Cushing syndrome caused by a pituitary tumor or tumor that releases ACTH: .
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

^ A pituitary tumor often causes too little ACTH to be produced.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Cushing's Syndrome was also the first autoimmune disease identified in humans.^ This form of the syndrome is known as Cushing's disease.
  • August 23, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ What is the difference between Cushing's disease and Cushing's syndrome?

^ Cushing 's disease is a form of Cushing syndrome .
  • Cushing Syndrome | LIVESTRONG.COM 19 January 2010 18:38 UTC www.livestrong.com [Source type: General]

[6]

Treatment

.Most Cushing's syndrome cases are caused by steroid medications (iatrogenic).^ Pituitary Adenoma : Pituitary adenomas cause most cases of Cushing's syndrome .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Familial Cushing's Syndrome : Most cases of Cushing's syndrome are not inherited.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ MedicineNet: What causes Cushing's syndrome?
  • Cushing's Syndrome - OrganizedWisdom Health 19 January 2010 18:38 UTC organizedwisdom.com [Source type: General]

.Consequently, most patients are effectively treated by carefully tapering off (and eventually stopping) the medication that causes the symptoms.^ With these canine patients, the symptoms themselves are treated and not the root cause.
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

^ This eMedTV article discusses this medical condition in detail, including information about symptoms they may cause and treatment options for the tumors.

^ The most common cause of Cushing's syndrome is the use of oral corticosteroid medication.
  • Cushing's Syndrome - Definition, Causes, Symptoms and Treatment 16 September 2009 22:23 UTC www.articlesbase.com [Source type: Academic]

.If an adrenal adenoma is identified it may be removed by surgery.^ The surgery to remove the cancerous adrenal gland is called an adrenalectomy.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ If this surgery fails (50/50 chance) she will need to have her healthy adrenals removed.
  • June 21, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ Surgery is needed to remove one of the adrenal glands if the gland has a tumor, and both glands if the problem is PD. If both glands are removed the cat has to be on supplemental cortisone and mineralcorticoids for the rest of its life.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

.An ACTH-secreting corticotrophic pituitary adenoma should be removed after diagnosis.^ This value is normally low as the negative feedback cycle to the anterior pituitary gland will suppress the body's own ACTH hormone secretion.
  • Cushing's disease and Cushing's syndrome - WebHealth 19 January 2010 18:38 UTC webhealth.com [Source type: Academic]

^ With Cushing's disease the ACTH production of the pituitary adenoma will usually not get suppressed thus suggesting a pituitary cause for the Cushing's disease.
  • Cushing's disease and Cushing's syndrome - WebHealth 19 January 2010 18:38 UTC webhealth.com [Source type: Academic]

^ Pituitary adenomas are functional tumors a description indicating that they secrete hormones.
  • Cushings Disease 12 October 2009 10:50 UTC www.horse101.com [Source type: FILTERED WITH BAYES]
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

.Regardless of the adenoma's location, most patients will require steroid replacement postoperatively at least in the interim as long-term suppression of pituitary ACTH and normal adrenal tissue does not recover immediately.^ Most patients have a single adenoma .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ None of the patients required steroid replacement.
  • June 21, 2006 Cushing's Help and Support/Newsletters 22 September 2009 15:015 UTC www.cushingsonline.com [Source type: FILTERED WITH BAYES]

^ Cushing's disease specifically refers to a tumor in the pituitary gland that stimulates excessive release of cortisol from the adrenal glands by releasing large amounts of ACTH. In Cushing's syndrome , ACTH levels will normally drop due to negative feedback from the high levels of cortisol.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

.Clearly, if both adrenals are removed, replacement with hydrocortisone or prednisolone is imperative.^ If that is not possible to arrange the other option to consider in a cat is surgical removal of both adrenal glands.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ Surgery is needed to remove one of the adrenal glands if the gland has a tumor, and both glands if the problem is PD. If both glands are removed the cat has to be on supplemental cortisone and mineralcorticoids for the rest of its life.
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ BLA, Bilateral Adrenalectomy: Surgical removal of both the adrenal glands.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.In those patients not suitable for or unwilling to undergo surgery, several drugs have been found to inhibit cortisol synthesis (e.g.^ The drug works by interfering with cortisol synthesis to prevent excess cortisol production.
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

^ Chemotherapy and a cortisol inhibiting medication called Mitotane may also be used and sometimes in combination with other hormone inhibiting drugs and sometimes in combination with radiotherapy and treatment will meet with individual needs.
  • cushings syndrome 16 September 2009 22:23 UTC www.well-women.com [Source type: Original source]

^ Physiology The amount of cortisol present in the serum undergoes diurnal variation, with the highest levels present in the early morning, and lower levels in the evening, several hours after the onset of sleep.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

ketoconazole, metyrapone) but they are of limited efficacy.
.Removal of the adrenals in the absence of a known tumor is occasionally performed to eliminate the production of excess cortisol.^ Adrenal tumors release cortisol.
  • Adrenal tumor - Cushing syndrome 18 September 2009 5:35 UTC diseasereference.net [Source type: Academic]

^ How it works: Lysodren acts to suppress adrenal gland function by eroding the top layers of the adrenal gland that produce corticosteroid hormones, thereby reducing the production of cortisol.
  • Lysodren: Cushings Disease Treatment For Dogs - 1800PetMeds 12 October 2009 10:50 UTC www.1800petmeds.com [Source type: General]

^ Adrenalectomy: Surgical removal of the adrenal glands is a final measure for halting excess cortisol production This is used only when all other measures fail in individuals with pituitary tumors.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.In some occasions, this removes negative feedback from a previously occult pituitary adenoma, which starts growing rapidly and produces extreme levels of ACTH, leading to hyperpigmentation.^ Cushing's disease specifically refers to a tumor in the pituitary gland that stimulates excessive release of cortisol from the adrenal glands by releasing large amounts of ACTH. In Cushing's syndrome , ACTH levels will normally drop due to negative feedback from the high levels of cortisol.
  • Welcome! / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: General]

^ This excess cortisol is monitored by the hypothalamus and pituitary in the negative feedback mechanism, causing them to secrete less ACTH. Less ACTH in the bloodstream will cause the other adrenal (if it does not also have a tumor) to atrophy (shrink).
  • Cushing's Disease (hyperadrenocorticism) 22 September 2009 15:015 UTC www.lbah.com [Source type: FILTERED WITH BAYES]

^ The pituitary gland, located at the base of the brain, produces ACTH (adrenocorticotrophic hormone), as directed by the hypothalamus (another part of the brain).
  • Pet Owner's Crash Course in Canine Cushing's Disease 12 October 2009 10:50 UTC www.kateconnick.com [Source type: FILTERED WITH BAYES]

This clinical situation is known as Nelson's syndrome.[7]

Epidemiology

.Iatrogenic Cushing's syndrome (caused by treatment with corticosteroids) is the most common form of Cushing's syndrome.^ Pituitary Adenoma : Pituitary adenomas cause most cases of Cushing's syndrome .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Pergolide treatment for Cushing's syndrome in a horse.
  • Cushings Disease 12 October 2009 10:50 UTC www.horse101.com [Source type: FILTERED WITH BAYES]
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

^ Cushing's Syndrome treatment in horses .
  • Horse Disease 16 September 2009 22:23 UTC www.horse101.com [Source type: FILTERED WITH BAYES]

.The incidence of pituitary tumors may be relatively high, as much as one in five people,[8] but only a minute fraction are active and produce excessive hormones.^ Sometimes only one pituitary hormone is missing.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Nonfunctioning pituitary tumors Nonfunctioning tumors do not produce hormones .
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

^ Isolated luteinizing hormone deficiency: Only one pituitary hormone, the luteinizing hormone, is missing.
  • Cushing's Glossary / Cushings-Help.com Support for Cushing's Syndrome and Cushing's Disease 12 October 2009 10:50 UTC www.cushings-help.com [Source type: Academic]

.Adults with the disease may also have symptoms of extreme weight gain, excess hair growth in women, high blood pressure, and skin problems.^ Many women gain weight on glucophage.
  • Female Facial Hair | RateMDs.com 19 January 2010 18:38 UTC www.ratemds.com [Source type: General]

^ The symptoms of Cushing’s disease may include any of the following problems: increased drinking and urinating, increased appetite, panting, a pendulous appearance to the abdomen, increased susceptibility to urinary bladder and skin infections, decreased exercise tolerance, weight gain, hair loss (often in a symmetrical pattern), testicular atrophy, increased pigmentation of the skin, thinning of the skin (especially noticeable in cats), muscle weakness, calcium deposits in the skin (calcinosis cutis) or less commonly in internal organs and a bulging appearance to the eyes.
  • Cushing's Disease in Cats 22 September 2009 15:015 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

^ Cushing's disease causes increased drinking, increased urination, increased appetite, panting, high blood pressure, hair loss - usually evenly distributed on both sides of the body, pendulous abdomen, thinning of the skin, calcified lumps in the skin, susceptibility to skin infections and diabetes, weakening of the heart and skeletal muscles, nervous system disease and other symptoms.
  • Cushing's Disease in Dogs - What is it, and how do we treat it? 12 October 2009 10:50 UTC www.vetinfo.com [Source type: FILTERED WITH BAYES]

In addition, they may show:
  • muscle and bone weakness
  • moodiness, irritability, or depression
  • sleep disturbances
  • high blood sugar
  • menstrual disorders in women and decreased fertility in men
  • baldness
  • hypercholesterolemia

References

  1. ^ Kumar, Abbas, Fausto. Robbins and Cotran Pathologic Basis of Disease, 7th ed. Elsevier-Saunders; New York, 2005.
  2. ^ Cushing HW. (1932). "The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism).". Bull Johns Hopkins Hosp 50: 137–95. 
  3. ^ Yudofsky, Stuart C.; Robert E. Hales (2007). The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences (5th ed.). American Psychiatric Pub, Inc.. ISBN 1585622397. 
  4. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  5. ^ Raff H, Findling JW (2003). "A physiologic approach to diagnosis of the Cushing syndrome". Ann. Intern. Med. 138 (12): 980–91. PMID 12809455. http://www.annals.org/cgi/pmidlookup?view=long&pmid=12809455. 
  6. ^ The History of Cushings Disease: a controversial tale, J R Soc Med. 1991 June; 84(6): 363–366
  7. ^ Nelson DH, Meakin JW, Thorn GW (1960). "ACTH-producing pituitary tumors following adrenalectomy for Cushing syndrome". Ann. Intern. Med. 52: 560–9. PMID 14426442. 
  8. ^ Ezzat S, Asa SL, Couldwell WT, et al. (2004). "The prevalence of pituitary adenomas: a systematic review". Cancer 101 (3): 613–9. doi:10.1002/cncr.20412. PMID 15274075. 

Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

English

Noun

Singular
Cushing's syndrome
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Wikipedia has an article on:
  1. (medicine) Hyperadrenocorticism or hypercorticism, an endocrine disorder caused by high levels of cortisol in the blood.







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