Abstract Cushing’s syndrome is an endocrine disorder resulting from excess levels of cortisol in the blood. The etiology can be exogenous or endogenous, which can be further broken down into adrenocorticotropic hormone (ACTH) dependent and independent. The pathogenesis of Cushing’s syndrome depends on the cause, and generally results in the disruption of the normal functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Cushing’s syndrome is characterized by a variety of signs and symptoms, and treatment varies depending on the etiology. Currently research is being conducted on diagnostic tests for this disorder.
Introduction
Cushing’s syndrome is an endocrine disorder that is characterized by multiple signs and symptoms resulting
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Endogenous Cushing’s syndrome results when the high levels of cortisol originate from within the body. The most common causes of endogenous Cushing’s syndrome are adrenal, pituitary or ectopic tumours. These tumours lead to a disruption of the normal functioning of the HPA axis. Exogenous Cushing’s syndrome results when the high levels of cortisol in the blood is a direct result of some factor outside of the body, such as the administration of therapeutic steroids (Bronstein 2011). The endogenous component of Cushing’s syndrome can be further broken down into ACTH dependent and ACTH independent. ACTH-dependent causes account for the majority of cases (80%) (Bronstein 2011). Pituitary adenomas account for 80% of ACTH-dependent causes, with the remaining 20% resulting from ectopic tumours. These ectopic tumours are generally small-cell carcinomas of the lungs, but may also result from endocrine tumours on a variety of organs (Newell-Price et al. 2006). ACTH-independent causes typically result from various tumours on the adrenal glands, resulting in the direct secretion of cortisol into the blood. In extremely rare cases, ACTH-independent Cushing’s syndrome can be caused by corticotropin-independent macronodular adrenal disease and McCune-Albright syndrome (Newell-Price et al. 2006).
Pathogenesis
Once a diagnosis of Cushing’s syndrome is confirmed, the cause of this syndrome must be determined. Each subsequent cause has
Another diagnostic method to diagnose adrenal tumors is cortisol saliva testing. In this test, the amount of cortisol in the saliva at or near midnight is normally very low. Multiple repeats of the test to confirm elevated cortisol levels can diagnose Cushing's syndrome. Cushing's syndrome is excess cortisol levels, possibly due to the body secreting too much
themselves are malfunctioning that is called primary adrenal insufficiency. Another reason that cortisol production is lacking might be because not enough ACTH is being generated by the pituitary gland. The second order effect of inadequate levels of ACTH being secreted results in cortisol not being produced. When this is the case it is called secondary adrenal insufficiency (MedlinePlus, 2011).
There are many various conditions and diseases affecting the endocrine system. Here we will discuss several and describe the endocrine gland, hormone, target tissue, symptoms, causes, and treatment options.
Cushing’s syndrome is a rare endocrine disorder that occurs when your body is exposed to an overabundance of the hormone cortisol.3 Cortisol is known as the stress hormone. The interruption of cortisol secretion can cause weight gain and can ultimately determine where you put the weight on.8 There are many underlying causes such as Pituitary Adenomas, Ectopic ACTH Syndrome, Adrenal Tumors, and Familial Cushing’s Syndrome.2 The majority of these people affected by this hormonal disorder experience weak muscles, increase fat, high blood pressure, etc.1 Although thousands are affected in various ways, there are currently several channels of treatment administered by medical professionals. Through the use of improving technology, medical professionals are better understanding the disorder, allowing them to develop better treatment practices.
Cushing 's syndrome (CS) is characterized by pathologically elevated free glucocorticoid levels. Endogenous hypercortisolism is usually due to ACTH-secreting pituitary corticotropic adenomas and less often due to ectopic ACTH-secreting neuroendocrine neoplasms or ACTH-independent adrenal cortisol hypersecretion (Yaneva, 2010). Cushing 's disease occurs infrequently in an inherited setting in both of these conditions (Yaneva, 2010).
According to http://www.webmd.com/, “the adrenal glands don't make enough of a hormone called cortisol, or less often, a related hormone called aldosterone.” That's why doctors sometimes call the illness ''chronic adrenal insufficiency,'' or hypocortisolism. “most important function is to help the body respond to stress. It also helps regulate your body's use of protein, carbohydrates, and fat; helps maintain blood pressure and cardiovascular function; and controls inflammation.” Aldosterone helps your kidneys regulate the amount of salt and water in your body -- the main way you regulate blood volume and keep your blood pressure under control. When aldosterone levels drop too low, your kidneys cannot keep your salt and water levels in balance. This makes your blood pressure drop. “There are two forms of Addison's disease. If the problem is with the adrenal glands themselves, it's called primary adrenal insufficiency. If the adrenal glands are affected by a problem starting somewhere else -- such as the pituitary gland -- it's called secondary adrenal
When a dog has too much Cortisol in their body (usually in their adrenal glands), it can result in them getting Cushing's disease. It is the most common hormone related disease in dogs.There are other causes of this disease in dogs like taking medicine with Cortisol in it for a long period of time or having a tumor in the adrenal gland. However, the main cause of this disease in dogs is their bodies producing too much Cortisol.
Addison disease effects the Endocrine system because the adrenal glands doesn’t produce enough of the hormone cortisol which the brain sends to the adrenal instructing them to make cortisol called secondary adrenal insufficiency
According to Clark, Sutton, & Lucett, (2014), “cortisol is typically referred to as a catabolic hormone”. When your
Throughout the paper author Mark E. Molitch, a medical doctor, discusses the formation of pituitary tumors and the impact they have on the body. He describes how these adenomas form, what symptoms they cause, how they are diagnosed, and how they are treated. In the paper he addresses specific tumors such as Prolactinoma, which encompasses around half of all pituitary adenomas and causes an elevation in prolactin levels, as well as Acromegaly, a growth hormone secreting tumor, and Cushing disease which causes the overproduction of cortisol.
A review of a patient’s medical history based on the symptoms, especially the dark tanning of the skin, can lead a doctor to suspect Addison’s disease. The most specific test for diagnosing Addison’s disease is the ACTH stimulation test. In this test, urine and/or blood cortisol levels are measured before and after a synthetic form of ACTH is given by injection. Patients with either form of adrenal insufficiency will respond poorly or not at all. There is also an Insulin-Induced Hypoglycemia Test which is used to determine how the hypothalamus, pituitary and adrenal glands respond to stress. Blood is drawn to measure blood glucose and cortisol levels followed by an injection of fast-acting insulin. The normal response is for blood glucose levels to fall and cortisol levels to
functions of the HPA axis and the steroid hormone, cortisol, aid in identifying the precursors to
If the disease is primary, the pituitary gland may be sending out elevated levels of ACTH (adrenocorticotropic hormone) to try to get the adrenal cortex to produce more hormones. When the disease is secondary, the ACTH does not stimulate the adrenal cortex to produce more hormones (Understanding Medical Surgical Nursing, 2015). Only 1 out of 100,000 people actually have Addison’s disease; making it very rare. Addison’s disease occurs in men and women of any age (Understanding Addison’s Disease).
A disorder that takes place when your body produces an insufficient amount of certain hormones that are produced by the adrenal glands is called Addison’s disease. With Addison’s disease, the adrenal glands do not produce enough cortisol and often times an insufficient amount of aldosterone as well. Doctors sometimes refer to Addison’s disease as the illness of chronic adrenal insufficiency, or also called hypocortisolism.
Cushing’s Syndrome is a condition that results from chronic exposure to excessive amounts of glucocorticoids circulating in the blood stream for an extended period of time. The disease was first reported by Harvey Cushing over one hundred years ago, yet the condition still plagues endocrinologists today. Reasons for this difficulty include the vast amount of often vague symptoms that the syndrome presents, most of which are found in a plethora of other conditions as well, combined with the multiple forms that the condition can manifest itself. Symptoms of Cushings Syndrome include, but are not limited to, weight gain, hirutism, easy bruising, hypertension, acne, facial plethora, muscle weakness, striae, depression,