Cushing’s syndrome

Condition characterized by an excess of corticosteroids in the bloodstream. The most important corticosteroid is Cortisol, which regulates carbohydrate metabolism among other things, raising the blood sugar level and controlling inflammation reactions. The adrenal cortex also produces hormones which regulate water and salts in the body, and male sex hormones. Excess corticosteroid production can result from stimulation by a tumour on the adrenal cortex, or by a pituitary tumour, but Cushing’s syndrome usually follows treatment with artificial corticosteroids, much used because of their effectiveness in controlling inflammation in asthma and rheumatoid arthritis sufferers. The symptoms of the disorder develop slowly, starting with an accumulation of fat in the face and rump, and emaciation of limbs caused by muscle reduction. Bluish-red stripes like stretch marks in pregnancy appear on the rump; the skin is thin, easily bruised, and wounds heal poorly. Cortisol affects bone tissue metabolism, causing ostoporosis and weakening of the bones, so that even a slight injury can result in fracture, and increasing the risk of slipped discs. The increase in blood sugar can cause diabetes. Other symptoms are high blood pressure, menstrual difficulties and loss of libido. If the condition is caused by medication then the corticostreroid dose should be reduced and/or the disorder for which it was prescribed treated in other ways. But it is dangerous to reduce dosage on one’s own initiative, because this could lead to sudden acute corticosteroid deficiency, which is potentially fatal. If Cushing’s syndrome is caused by an adrenal or pituitary tumour, surgery or radiation treatment is required. Long-term use of corticosteroid tablets may then be necessary to control the deficiency.

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