Causes and risk factors
As the names suggests Cushing syndrome is caused due to excess of glucocorticoid hormone in the body. Increase levels of cortisol is primarily caused due to diseases of the pituitary gland like pituitary tumor. Various carcinomas also lead to development of Cushing’s syndrome .Lung carcinoma and medullar carcinoma of thyroid are the most common contributing factor. Overuse of steroid medications is one of the major contributing factors. Although rare breast, ovary, gall bladder and colon cancer can also cause Cushings syndrome.
Clinical presentation
A person suffering from Cushing’s syndrome has a typical presentation of moon face. There occurs excess growth of hair all over the body. Muscle weakness occurs. Changes at the level of the skin are also seen. Reddish purple discoloration on the skin occurs. An individual with Cushing’s syndrome becomes highly vulnerable to bruises. Easy bruises occurs. Females present menstrual irregularities .Delayed puberty and growth retardation occur in children.
Investigations and diagnosis
The diagnosis is done on the basis of the symptoms narrated by the patient and physical examination carried out by the doctor. Dexamethasone suppression test is diagnostic. Investigations like blood cortisol levels, Adrenocorticotropic hormone test, blood potassium levels along with urine tests are advised.MRI or CT scan of the brain are advised to detect the abnormalities in pituitary gland. Other investigations like routine blood test, lipid profile, Insulin resistance test and Loperamide test can also be advised.
Treatment
Adrenal steroid inhibitors and somtostatin analogs are the first line of tertament.In severe cases or in cases of tumors of the pituitary gland surgical intervention is adopted. Trans sphenoidal surgery or adrenalectomy can be done. Pituitary irradiation is done in cases where surgery fails. Use of radiation is done to destroy the tumor.
Other modes of treatment:
The other modes of treatment can also be effective in treating Cushings. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating the complaints.
