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Cushing's Syndrome

Name of disease:

Cushing's Syndrome

ICD-10 diagnosis code:

E24.0, D35.2

Causes:

  • Overuse of cortisol medication
  • Excess production of cortisol from a tumour in the adrenal gland or elsewhere in the body, or a tumour of the pituitary gland secreting adrenocorticotropic hormone which stimulates the over-production of cortisol from the adrenal gland

Mode of inheritance:

Most cases of Cushing's syndrome are not genetic. However, some individuals may develop Cushing's syndrome due to an inherited tendency to develop tumours of one or more endocrine glands.

Prevalence:

It is estimated about 10 - 15 per million people are affected every year in the US.

Diagnosis:

  • Medical history review
  • Physical exam
  • Lab tests of urine saliva or blood

Age of onset:

20 - 50 years old

Common signs and symptoms:

Signs and symptoms of Cushing’s syndrome vary. People who have very high levels of cortisol for a long time are likely to have clear signs of disorder, including:
  • Weight gain
  • Thin arms and legs
  • A round face
  • Increased fat around the base of the neck
  • A fatty hump between the shoulders
  • Easy bruising
  • Wide purple stretch marks mainly on the abdomen breasts hips and under the arms
  • Weak muscles

Available treatment (medicinal and non-medicinal):

  • If caused by taking steroids:
    • The steroid dose will be gradually reduced or stopped
  • If caused by a tumour treatment may include:
    • Surgery to remove the tumour
    • Radiotherapy to destroy the tumour
    • Medication to reduce the effect of cortisol on the body

Disease management tips:

  • Monitor vitals heart and lung status. (hypertension and fluid overload are common)
  • Eat a healthy diet that is high in protein and calcium. This can help prevent muscle and bone loss caused by the high cortisol levels in the body. Talk to the doctor about whether calcium and vitamin D supplement should be taken for bone health.
  • Limit salt (sodium) in the diet. This is very important if one has high blood pressure because of Cushing's syndrome.
  • Get exercise. Walking is a good choice to start with. Talk with the doctor about how much exercise is safe for the patient.
  • Get regular eye exams to check for glaucoma and cataracts.
  • See the doctor regularly to help diagnose and treat diabetes high blood pressure and other possible complications.

References:

Other useful websites:

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