Cushing's syndrome pathophysiology: Difference between revisions
| Line 8: | Line 8: | ||
==Pathophysiology== | ==Pathophysiology== | ||
Both the [[hypothalamus]] and the [[pituitary gland]] are | Both the [[hypothalamus]] and the [[pituitary gland]] are part of brain. The hypothalamus releases [[corticotropin-releasing hormone]] (CRH), which stimulates the pituitary gland to release corticotropin ([[ACTH]]). ACTH travels via the blood to the adrenal gland, where it stimulates the release of [[cortisol]]. Cortisol is secreted by the cortex of the [[adrenal gland]] from a region called the ''[[zona fasciculata]]'' in response to ACTH. Elevated levels of cortisol exert [[negative feedback]] on the pituitary, which decreases the amount of ACTH released from the pituitary gland. Strictly, '''Cushing's syndrome''' refers to excess cortisol of any etiology. One of the causes of Cushing's syndrome is a cortisol secreting adenoma in the cortex of the adrenal gland. The adenoma causes cortisol levels in the blood to be very high, and negative feedback on the pituitary from the high cortisol levels causes ACTH levels to be very low. '''Cushing's disease''' refers only to hypercortisolism secondary to excess production of ACTH from a corticotrophic [[pituitary adenoma]]. This causes the blood ACTH levels to be elevated along with cortisol from the adrenal gland. The ACTH levels remain high because a tumor causes the pituitary to be unresponsive to negative feedback from high cortisol levels. | ||
Cortisol can also exhibit [[mineralcorticoid]] activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion). | Cortisol can also exhibit [[mineralcorticoid]] activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion). | ||
Revision as of 15:56, 18 August 2015
|
Cushing's syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Cushing's syndrome pathophysiology On the Web |
|
American Roentgen Ray Society Images of Cushing's syndrome pathophysiology |
|
Risk calculators and risk factors for Cushing's syndrome pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Both the hypothalamus and the pituitary gland are part of brain. The hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to release corticotropin (ACTH). ACTH travels via the blood to the adrenal gland, where it stimulates the release of cortisol. Cortisol is secreted by the cortex of the adrenal gland from a region called the zona fasciculata in response to ACTH. Elevated levels of cortisol exert negative feedback on the pituitary, which decreases the amount of ACTH released from the pituitary gland. Strictly, Cushing's syndrome refers to excess cortisol of any etiology. One of the causes of Cushing's syndrome is a cortisol secreting adenoma in the cortex of the adrenal gland. The adenoma causes cortisol levels in the blood to be very high, and negative feedback on the pituitary from the high cortisol levels causes ACTH levels to be very low. Cushing's disease refers only to hypercortisolism secondary to excess production of ACTH from a corticotrophic pituitary adenoma. This causes the blood ACTH levels to be elevated along with cortisol from the adrenal gland. The ACTH levels remain high because a tumor causes the pituitary to be unresponsive to negative feedback from high cortisol levels.
Cortisol can also exhibit mineralcorticoid activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion).