Cushing's syndrome causes: Difference between revisions

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Latest revision as of 00:23, 30 August 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S [2]

Overview

Cushing’s syndrome occurs when the body’s tissues are exposed to high levels of corticosteroids for a long period. Many people develop Cushing’s syndrome because they take glucocorticoids, (steroid hormones that are chemically similar to naturally produced cortisol) such as prednisone for asthma, rheumatoid arthritis, lupus, and other inflammatory diseases. Glucocorticoids are also used to suppress the immune system after transplantation to keep the body from rejecting the new organ or tissue. Other people develop Cushing’s syndrome because their bodies produce too much cortisol due to adrenal or extra-adrenal causes.

Causes

The major causes of Cushing's syndrome are:^[1]^[2]^[3]^[4]^[5]

Excess ACTH secretion
- Pituitary Adenomas: These benign, or noncancerous, tumors of the pituitary gland secrete extra ACTH. Most people with the disorder have a single adenoma. This form of the syndrome is known as Cushing’s disease.
- Ectopic ACTH Syndrome: Some benign or more often, cancerous tumors that arise outside the pituitary can produce ACTH. This condition is known as ectopic ACTH syndrome. Lung cancer causes more than half of these cases. Rarely, bronchial and thymic carcinoids also cause ectopic secretion of ACTH.
Excess secretion of cortisol by adrenal glands:
- Adrenal Tumors: In rare cases, an abnormality of the adrenal glands, most often an adrenal tumor, causes Cushing’s syndrome. Adrenal tumors are four to five times more common in women than men, and the average age of onset is about 40. Most of these cases involve noncancerous tumors of adrenal tissue called adrenal adenomas, which secrete excess cortisol.
- Adrenocortical carcinomas (Adrenal cancers): These are the least common cause of Cushing’s syndrome. With adrenocortical carcinomas, cancer cells secrete excess levels of several adrenocortical hormones, including cortisol and adrenal androgens, a type of male hormone. Adrenocortical carcinomas usually cause very high hormone levels and rapid development of symptoms.

Familial Cushing’s Syndrome

Most cases of Cushing’s syndrome are not inherited. Rarely, however, Cushing’s syndrome results from an inherited tendency to develop tumors of one or more endocrine glands. Endocrine glands release hormones into the bloodstream. With primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the adrenal glands. With multiple endocrine neoplasia type 1 (MEN1), hormone-secreting tumors of the parathyroid glands, pancreas, and pituitary develop; Cushing’s syndrome in MEN1 may be due to pituitary, ectopic, or adrenal tumors.

Drugs

The following drugs can also cause the Cushing's syndrome.

References

↑ Lacroix A, Feelders RA, Stratakis CA, Nieman LK (2015). "Cushing's syndrome". Lancet. 386 (9996): 913–27. doi:10.1016/S0140-6736(14)61375-1. PMID 26004339.
↑ Raff H, Carroll T (2015). "Cushing's syndrome: from physiological principles to diagnosis and clinical care". J. Physiol. (Lond.). 593 (3): 493–506. doi:10.1113/jphysiol.2014.282871. PMC 4324701. PMID 25480800.
↑ Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD (2014). "Adrenocortical carcinoma". Endocr. Rev. 35 (2): 282–326. doi:10.1210/er.2013-1029. PMC 3963263. PMID 24423978.
↑ Vyas S, Gorsi U, Bansali A, Khandelwal N (2012). "Anterior mediastinal mass in a patient with Cushing's syndrome". Ann Thorac Med. 7 (1): 42–3. doi:10.4103/1817-1737.91557. PMC 3277041. PMID 22347350.
↑ "Cushing's Syndrome due to Ectopic ACTH from Bronchial Carcinoid: A Case Report and Review".

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[pmid26004339-1] Lacroix A, Feelders RA, Stratakis CA, Nieman LK (2015). "Cushing's syndrome". Lancet. 386 (9996): 913–27. doi:10.1016/S0140-6736(14)61375-1. PMID 26004339.

[pmid25480800-2] Raff H, Carroll T (2015). "Cushing's syndrome: from physiological principles to diagnosis and clinical care". J. Physiol. (Lond.). 593 (3): 493–506. doi:10.1113/jphysiol.2014.282871. PMC 4324701. PMID 25480800.

[pmid24423978-3] Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD (2014). "Adrenocortical carcinoma". Endocr. Rev. 35 (2): 282–326. doi:10.1210/er.2013-1029. PMC 3963263. PMID 24423978.

[pmid22347350-4] Vyas S, Gorsi U, Bansali A, Khandelwal N (2012). "Anterior mediastinal mass in a patient with Cushing's syndrome". Ann Thorac Med. 7 (1): 42–3. doi:10.4103/1817-1737.91557. PMC 3277041. PMID 22347350.

[urlCushing’s_Syndrome_due_to_Ectopic_ACTH_from_Bronchial_Carcinoid:_A_Case_Report_and_Review-5] "Cushing's Syndrome due to Ectopic ACTH from Bronchial Carcinoid: A Case Report and Review".

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[4]

[5]

@@ Line 5: / Line 5: @@
 ==Overview==
-Cushing’s syndrome occurs when the body’s tissues are exposed to high levels of [[cortisol]] for a long period. Many people develop Cushing’s syndrome because they take [[glucocorticoids—steroid hormone]]s that are chemically similar to naturally produced cortisol—such as prednisone for [[asthma]], [[rheumatoid]] [[arthritis]], [[lupus]], and other inflammatory diseases. [[Glucocorticoid]]s are also used to suppress the [[immune system]] after [[transplantation]] to keep the body from rejecting the new [[organ]] or tissue.
+Cushing’s syndrome occurs when the body’s tissues are exposed to high levels of [[corticosteroids]] for a long period. Many people develop Cushing’s syndrome because they take [[glucocorticoids]], ([[steroid hormones]] that are chemically similar to naturally produced [[cortisol]]) such as [[prednisone]] for [[asthma]], [[Rheumatoid Arteritis|rheumatoid arthritis]], [[lupus]], and other [[inflammatory diseases]]. [[Glucocorticoid]]s are also used to suppress the [[immune system]] after [[transplantation]] to keep the body from rejecting the new organ or tissue. Other people develop Cushing’s syndrome because their bodies produce too much [[cortisol]] due to adrenal or extra-adrenal causes.
-Other people develop Cushing’s syndrome because their bodies produce too much [[cortisol]] from due to adrenal or extra-adrenal causes.
 ==Causes==
-The major causes of Cushing's syndrome are:<ref name="pmid26004339">{{cite journal |vauthors=Lacroix A, Feelders RA, Stratakis CA, Nieman LK |title=Cushing's syndrome |journal=Lancet |volume=386 |issue=9996 |pages=913–27 |year=2015 |pmid=26004339 |doi=10.1016/S0140-6736(14)61375-1 |url=}}</ref><ref name="pmid25480800">{{cite journal |vauthors=Raff H, Carroll T |title=Cushing's syndrome: from physiological principles to diagnosis and clinical care |journal=J. Physiol. (Lond.) |volume=593 |issue=3 |pages=493–506 |year=2015 |pmid=25480800 |pmc=4324701 |doi=10.1113/jphysiol.2014.282871 |url=}}</ref><ref name="pmid24423978">{{cite journal |vauthors=Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD |title=Adrenocortical carcinoma |journal=Endocr. Rev. |volume=35 |issue=2 |pages=282–326 |year=2014 |pmid=24423978 |pmc=3963263 |doi=10.1210/er.2013-1029 |url=}}</ref>
+The major causes of Cushing's syndrome are:<ref name="pmid26004339">{{cite journal |vauthors=Lacroix A, Feelders RA, Stratakis CA, Nieman LK |title=Cushing's syndrome |journal=Lancet |volume=386 |issue=9996 |pages=913–27 |year=2015 |pmid=26004339 |doi=10.1016/S0140-6736(14)61375-1 |url=}}</ref><ref name="pmid25480800">{{cite journal |vauthors=Raff H, Carroll T |title=Cushing's syndrome: from physiological principles to diagnosis and clinical care |journal=J. Physiol. (Lond.) |volume=593 |issue=3 |pages=493–506 |year=2015 |pmid=25480800 |pmc=4324701 |doi=10.1113/jphysiol.2014.282871 |url=}}</ref><ref name="pmid24423978">{{cite journal |vauthors=Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD |title=Adrenocortical carcinoma |journal=Endocr. Rev. |volume=35 |issue=2 |pages=282–326 |year=2014 |pmid=24423978 |pmc=3963263 |doi=10.1210/er.2013-1029 |url=}}</ref><ref name="pmid22347350">{{cite journal |vauthors=Vyas S, Gorsi U, Bansali A, Khandelwal N |title=Anterior mediastinal mass in a patient with Cushing's syndrome |journal=Ann Thorac Med |volume=7 |issue=1 |pages=42–3 |year=2012 |pmid=22347350 |pmc=3277041 |doi=10.4103/1817-1737.91557 |url=}}</ref><ref name="urlCushing’s Syndrome due to Ectopic ACTH from Bronchial Carcinoid: A Case Report and Review">{{cite web |url=https://www.hindawi.com/journals/crie/2012/215038/ |title=Cushing’s Syndrome due to Ectopic ACTH from Bronchial Carcinoid: A Case Report and Review |format= |work= |accessdate=}}</ref>
-#Excess ACTH sectretion
+*Excess [[ACTH]] secretion
-#*'''Pituitary Adenomas:'''These benign, or noncancerous, tumors of the [[pituitary gland]] secrete extra ACTH. Most people with the disorder have a single adenoma. This form of the syndrome, known as Cushing’s disease.
+**'''[[Pituitary adenoma|Pituitary Adenomas]]:''' These [[benign]], or noncancerous, tumors of the [[pituitary gland]] secrete extra [[ACTH]]. Most people with the disorder have a single [[adenoma]]. This form of the syndrome is known as [[Cushing’s disease]].
-#*'''Ectopic ACTH Syndrome:'''Some benign or, more often, cancerous tumors that arise outside the pituitary can produce ACTH. This condition is known as ectopic ACTH syndrome. Lung tumors cause more than half of these cases.
+**'''[[Ectopic ACTH Syndrome]]:''' Some [[benign]] or more often, cancerous tumors that arise outside the [[pituitary]] can produce [[ACTH]]. This condition is known as [[Ectopic ACTH Syndrome|ectopic ACTH syndrome]]. [[Lung cancer]] causes more than half of these cases. Rarely, bronchial and thymic carcinoids also cause ectopic secretion of ACTH.
-#Excess secretion of cortisol by adrenal glands:
+*Excess secretion of [[cortisol]] by [[adrenal glands]]:
-#*'''Adrenal Tumors:'''In rare cases, an abnormality of the adrenal glands, most often an [[adrenal tumor]], causes Cushing’s syndrome. Adrenal tumors are four to five times more common in women than men, and the average age of onset is about 40. Most of these cases involve noncancerous tumors of adrenal tissue called adrenal [[adenomas]], which release excess [[cortisol]] into the blood.
+**'''[[Adrenal Tumor|Adrenal Tumors]]:''' In rare cases, an abnormality of the adrenal glands, most often an [[adrenal tumor]], causes Cushing’s syndrome. Adrenal tumors are four to five times more common in women than men, and the average age of onset is about 40. Most of these cases involve noncancerous tumors of adrenal tissue called adrenal [[adenomas]], which secrete excess [[cortisol]].
-#*'''Adrenocortical carcinomas—adrenal cancers:'''These are the least common cause of Cushing’s syndrome. With adrenocortical carcinomas, cancer cells secrete excess levels of several [[adrenocortical hormone]]s, including cortisol and adrenal [[androgen]]s, a type of male hormone. Adrenocortical carcinomas usually cause very high hormone levels and rapid development of symptoms.
+**'''[[Adrenocortical carcinoma|Adrenocortical carcinomas]] (Adrenal cancers):''' These are the least common cause of Cushing’s syndrome. With [[Adrenocortical carcinoma|adrenocortical carcinomas]], cancer cells secrete excess levels of several [[adrenocortical hormone]]s, including [[cortisol]] and adrenal [[androgen]]s, a type of male hormone. [[Adrenocortical carcinoma|Adrenocortical carcinomas]] usually cause very high hormone levels and rapid development of symptoms.
 '''Familial Cushing’s Syndrome'''
-*Most cases of Cushing’s syndrome are not inherited. Rarely, however, Cushing’s syndrome results from an inherited tendency to develop tumors of one or more endocrine glands. Endocrine glands release hormones into the bloodstream. With primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the adrenal glands. With [[multiple endocrine neoplasia type 1]] (MEN1), hormone-secreting tumors of the [[parathyroid gland]]s, [[pancreas]], and [[pituitary]] develop; Cushing’s syndrome in MEN1 may be due to pituitary, ectopic, or adrenal tumors.
+*Most cases of Cushing’s syndrome are not inherited. Rarely, however, Cushing’s syndrome results from an inherited tendency to develop tumors of one or more endocrine glands. [[Endocrine glands]] release hormones into the bloodstream. With primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the [[adrenal glands]]. With [[multiple endocrine neoplasia type 1]] ([[MEN1]]), hormone-secreting tumors of the [[parathyroid gland]]s, [[pancreas]], and [[pituitary]] develop; Cushing’s syndrome in [[MEN1]] may be due to [[pituitary]], [[ectopic]], or [[Adrenal tumor|adrenal tumors]].
 ===Drugs===