Cushing's syndrome involves a group of diseases in which there is a long-term chronic effects on the body of excess hormones of the adrenal cortex, regardless of the reason that caused the increase in the amount of these hormones in the blood.
The cause of Cushing's syndrome may have different states. Most often, Cushing's syndrome (excessive formation of adrenal hormones) is due to increased production of pituitary adrenocorticotropic hormone (Cushing's disease). This hormone can be produced by the pituitary microadenoma or ektopirovannoy (located not in the usual place) kortikotropinomoy. Ektopirovannaya malignant kortikotropinoma can be located in the bronchi, testes, ovaries.
Cushing's syndrome rarely occurs in the primary lesion of the adrenal cortex (benign or malignant tumors of the adrenal cortex, adrenal hyperplasia). Hormonally active tumor of the adrenal cortex is kortikosteroma. It produces in the blood of excessive amounts of glucocorticoids. At the same time due to excessive amounts of glucocorticoids in the blood decreases the amount of adrenocorticotropic hormone, pituitary, and adrenal rest tissue undergoes atrophic changes.
Cushing's syndrome may occur in the treatment of various diseases with adrenal cortex hormones (glucocorticoids), if a drug overdose. Occasionally there are unusual symptoms of hypercorticism due to eating, drinking and alcohol poisoning.
Cushing's syndrome there are the same type of exposure. Disturbed metabolism of proteins, fats and carbohydrates. Activated protein breakdown, produced excessive amounts of free fat in the blood, increases the amount of glucose in the blood that can lead to diabetes.
Manifestations of Cushing's disease are caused by excessive secretion of adrenal hormones, especially glucocorticoids.
The earliest sign of disease is obesity, with a typical deposition of fat in the face, neck, chest, abdomen. A person looks at this round, moon.
Appears on the cheeks purple blush.
Glucocorticoids cause increased appetite and alter metabolism, increasing blood glucose levels and increased fat deposition.
Limbs on the contrary become thin due to loss of mass of muscle tissue.
On the skin of the abdomen, shoulder, buttocks and thighs appear purplish-bluish band stretching - striae. This is the result of stretching of the skin with excessive deposition of fat and protein metabolism disorders, because the skin becomes thinner and easily stretched.
Appear on the skin of acne.
Wounds and cuts heal slowly.
In areas of friction in the collar on the neck, abdomen, elbows arises enhanced coloration of the skin. In these places, melanin is deposited, the amount of which increases with the number of adrenocorticotropic hormone.
Do women have hirsutism (excessive hairiness). Appear on the upper lip hair, chin, chest. Excessive hair growth in women is caused by increased production of male sex hormone androgen by the adrenal cortex, that women also causes the menstrual cycle.
In men, impotence occurs.
Initially, there is periodic, then the constant increase in blood pressure. Gradually developed bone loss - osteoporosis, which manifests itself first by pain in the bones and joints, then may have spontaneous fractures of the ribs and limbs. Excess glyukortikoidov is a violation of the formation of a protein basis bones and increases the yield of calcium from bone.
Patients complain of fatigue, headaches, weight gain. Sometimes patients with Cushing's disease lead to abnormalities in the psyche. Appear depressed, various sleep disorders, psychosis.
Treatment of Cushing syndrome.
The goal of treatment - normal levels of adrenal hormones in the blood. Applied medications reduce the production of hormones in the adrenal cortex - Nizoral, Mam, metapyron - for a long time.
Symptomatic treatment aimed at correcting the violations of the protein and carbohydrate metabolism, normalize blood pressure, heart failure treatment. If a patient kortikosteromy, made the unilateral removal of the adrenal gland (unilateral adrenalectomy).