The excess production of glucocorticoids by the adrenal cortex may be caused either by adrenal pathology itself (tumor, nodular hyperplasia) - Cushing's syndrome, or overproduction of ACTH (pituitary adenoma) - Cushing's disease.
The disease is characterized by Cushing's constantly increased activity of the pituitary gland and hyperplasia develops kortikotropov or ACTH - producing pituitary adenoma and hyperplasia of the adrenal cortex of both.
At the heart of Cushing's syndrome is the formation of benign or malignant tumor of the adrenal cortex.
For the clinical picture of Cushing's disease is characterized by
decrease in the rate of growth
weight gain
uneven distribution of fat
hirsutism
striae
arterial hypertension
hyperpigmentation
muscular weakness
amenorrhea.
Cushing's syndrome in clinical manifestations is not very different from Cushing's disease. Depending on the degree of myopathic syndrome, venous disorders, steroid diabetes, high blood pressure are distinguished:
easy
moderate
severe form of Cushing's disease.
In the mild form there is a combination of 4.3 characteristic symptom of Cushing (dysplastic obesity, trophic skin disorders, mild hypertension and sexual dysfunction, poorly defined osteoporosis).
At moderate develop almost all manifestations of Cushing, but without the complications of the cardiovascular, skeletal, immune and other systems.
Severe form of pituitary Cushing's syndrome is characterized by a pronounced hypercortisolism and complications (cardiac decompensation, osteoporosis with multiple compression fractures of vertebral bodies and broken ribs, suppurative processes with potential septicopyemic, severe pyelonephritis with the development of chronic renal failure).
The presence of steroid psychosis evidence of severe Cushing's disease. Distinguish rapidly progressive course (characterized by the rapid growth of Cushing syndrome from 3 to 6 months.) And torpid course (seen relatively slow development of hyperactivity of the adrenal cortex).
The disease is characterized by Cushing's simultaneous increase in blood ACTH and cortisol, as well as increased daily urinary excretion of free cortisol and 17-hydroxycorticosteroids.
Treatment of pituitary Cushing's surgical, medical and radiation. Used as a combination and monotherapy.
