Cushing's disease

Cushing's disease
Cushing's disease
Classification and external resources
ICD-10 E24.0

Cushing's disease is a cause of Cushing's Syndrome characterised by increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary. This is most often as a result of a pituitary adenoma. Pituitary adenomas are responsible for 70% of endogenous Cushing's syndrome,[1] that is, when excluding Cushing's syndrome from exogenously administered corticosteroids, which is the major cause of Cushing's syndrome.

Contents

Signs and Symptoms

The condition is characterised by mainly the same features as Cushing's Syndrome with the added condition that ACTH levels are also elevated, despite the elevated levels of glucocorticoids such as cortisol.

History

The Soviet neurologist Nikolai Mikhailovich Itsenko in 1924 reported two patients.[citation needed] The American surgeon Harvey Cushing in 1932 described the clinical syndromes.[citation needed]

Diagnosis

Diagnosis is made first by diagnosis of Cushing's Syndrome which involves the 1 mg dexamethasone suppression test. If the patient has Cushing's Syndrome, the 8 mg dexamethasone suppression test is carried out which will confirm the aetiology of the disease.

Following the 8 mg dexamethasone suppression test plasma cortisol should be low; while plasma ACTH should be at the higher end of normal or should exceed the reference range. This will distinguish whether the cause is an ectopic ACTH secreting tumour, an adrenal carcinoma or an adrenal adenoma - ranges differ between different labs.

A CT or MRI of the pituitary may also show the ACTH secreting tumour if present.

Administration of corticotropin releasing hormone (CRH) can differentiate this condition from ectopic ACTH secretion. If ectopic, the plasma ACTH and cortisol levels should remain unchanged; if this is pituitary related, levels of both would rise.

Treatment

Treatment of a pituitary adenoma would probably involve surgery (transphenoidal hypophysectomy).

See also

References

  1. ^ Cushing’s Syndrome at The National Endocrine and Metabolic Diseases Information Service. July 2008. In turn citing: Nieman LK, Ilias I. Evaluation and treatment of Cushing’s syndrome. The Journal of American Medicine. 2005;118(12):1340–1346.

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Look at other dictionaries:

  • Cushing's disease — [koosh′iŋz] n. [after CUSHING Harvey (Williams)] a disorder of the adrenal cortex caused by a tumor in the pituitary, characterized by obesity, hypertension, diabetes mellitus, etc …   English World dictionary

  • Cushing's disease — Cush·ing s disease .ku̇sh iŋz n Cushing s syndrome esp. when caused by excessive production of ACTH by the pituitary gland Cushing Harvey Williams (1869 1939) American neurosurgeon. Cushing first gained a reputation by publishing an important… …   Medical dictionary

  • Cushing's disease — Pathol. a disease characterized by abnormal accumulations of facial and trunk fat, fatigue, hypertension, and osteoporosis, caused by hyperfunction of the adrenal cortex or administration of adrenal cortical hormones. Also called Cushing s… …   Universalium

  • Cushing's disease — Cush′ing s disease n. pat a disorder of metabolism caused by overproduction of the hormone ACTresulting in hypertension, striated skin, accumulations of fat on the face and other areas, and other disturbances • Etymology: 1935–40; after H. W.… …   From formal English to slang

  • Cushing's disease — noun Etymology: Harvey Cushing Date: circa 1935 Cushing s syndrome especially when caused by excessive production of ACTH by the pituitary gland …   New Collegiate Dictionary

  • Cushing's disease — noun a glandular disorder caused by excessive ACTH resulting in greater than normal functioning of the adrenal gland; characterized by obesity • Syn: ↑hyperadrenalism • Hypernyms: ↑glandular disease, ↑gland disease, ↑glandular disorder, ↑adenosis …   Useful english dictionary

  • Cushing's disease — noun Cushing s syndrome as caused by a tumour of the pituitary gland …   English new terms dictionary

  • Cushing's disease — /ˈkʊʃɪŋz dəziz/ (say kooshingz duhzeez) noun a condition in which the pituitary gland releases too much of the hormone ACTH; characterised by such symptoms as rapid weight gain, excessive sweating, thinning of the skin, and abnormal hair growth.… …   Australian-English dictionary

  • Cushing's syndrome — Classification and external resources ICD 10 E24 ICD 9 255.0 …   Wikipedia

  • Cushing's syndrome — n an abnormal bodily condition that is caused by excess corticosteroids and esp. cortisol usu. from adrenal or pituitary hyperfunction and that is characterized by a variety of signs and symptoms including esp. a change in appearance marked by… …   Medical dictionary

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