Cushing's Syndrome

Cushing's syndrome occurs when the body’s tissues are exposed to excessive levels of cortisol, a hormone which helps regulate glucose and fat metabolism. The condition develops when tumors of the pituitary or adrenal glands make too much hormone for long periods of time.  

Symptoms vary, but most people with Cushing’s, also called hypercortisolism, have upper body obesity with increased fat around the face and neck. Diabetes, hypertension, thin skin, muscle weakness, bruises, and fatigue are also common.

Though the more overt Cushing’s affects about one in every 5,000 to 10,000 people, milder, or subclinical, Cushing's syndrome may affect as many as one in every 1,000 people in the population.

Diagnosis

The classic manifestations of Cushing's syndrome, such as purple stretch marks and paper-thin skin, occur only in severe cases. Patients with overt Cushing's syndrome are generally diagnosed after a 24-hour urine collection for the hormone cortisol. Levels higher than 50 to 100 micrograms a day suggest Cushing's syndrome.

Doctors at UT Southwestern Medical Center also may diagnose Cushing's by performing a CT scan, a noninvasive scan that takes cross-sectional images to create a picture of the body, or X-rays to locate any tumors.

Treatment

Treatment of the condition depends on the cause. If it’s caused by use of a drug such as prednisone, doctors will decrease the dosage or stop the drug’s use. The condition may require surgery to remove tumors, or medications to block the release of cortisol.