Cushing's syndrome history and symptoms: Difference between revisions

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Revision as of 20:25, 23 August 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

History

Symptoms

Symptoms include

Rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity),
A round face often referred to as a "moon face",
Excess sweating,
Telangiectasia (dilation of capillaries),
The excess cortisol may also affect other endocrine systems and cause, for example,
- Insomnia
- Reduced libido
- Impotence
- Amenorrhoea
- Infertility.
Patients frequently suffer various psychological disturbances, ranging from euphoria to psychosis. Depression and anxiety are also common.^[1]

Furthermore, gastrointestinal disturbances, opportunistic infections and impaired wound healing (cortisol is a stress hormone, so it depresses the immune and inflammatory responses).

Osteoporosis is also problem in Cushing's Syndrome, as mentioned before, cortisol evokes a stress-like response. The body's maintenance of bone (and other tissues) is therefore no longer one of its main priorities, so to speak.

References

↑ Yudofsky, Stuart C. (2007). The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences (5th ed.). American Psychiatric Pub, Inc. ISBN 1585622397. Unknown parameter |coauthors= ignored (help)

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[1] Yudofsky, Stuart C. (2007). The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences (5th ed.). American Psychiatric Pub, Inc. ISBN 1585622397. Unknown parameter |coauthors= ignored (help)

[1]

@@ Line 9: / Line 9: @@
 ==Symptoms==
-Symptoms include rapid [[obesity|weight gain]], particularly of the trunk and face with sparing of the limbs ([[central obesity]]), a round face often referred to as a "[[moon face]]", excess [[sweating]], [[telangiectasia]] (dilation of capillaries), thinning of the skin (which causes easy bruising) and other mucous membranes, purple or red [[striae]] (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders), and [[hirsutism]] (facial male-pattern hair growth). A common sign is the growth of fat pads along the collar bone and on the back of the neck (known as a [[lipodystrophy]]). The excess cortisol may also affect other endocrine systems and cause, for example, insomnia, reduced [[libido]], [[impotence]], [[amenorrhoea]] and [[infertility]]. Patients frequently suffer various psychological disturbances, ranging from [[Euphoria (emotion)|euphoria]] to [[psychosis]]. [[clinical depression|Depression]] and [[anxiety]] are also common.<ref>{{cite book |title=The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences |last=Yudofsky |first=Stuart C. |coauthors=Robert E. Hales |edition=5th |year=2007 |publisher=American Psychiatric Pub, Inc. |isbn=1585622397 }}</ref>
+Symptoms include
+* Rapid [[obesity|weight gain]], particularly of the trunk and face with sparing of the limbs ([[central obesity]]),
+* A round face often referred to as a "[[moon face]]",
+* Excess [[sweating]],
+* [[Telangiectasia]] (dilation of capillaries),
+* The excess cortisol may also affect other endocrine systems and cause, for example,
+** [[Insomnia]]
+** Reduced [[libido]]
+** [[Impotence]]
+** [[Amenorrhoea]]
+** [[Infertility]].
+* Patients frequently suffer various psychological disturbances, ranging from [[Euphoria (emotion)|euphoria]] to [[psychosis]]. [[clinical depression|Depression]] and [[anxiety]] are also common.<ref>{{cite book |title=The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences |last=Yudofsky |first=Stuart C. |coauthors=Robert E. Hales |edition=5th |year=2007 |publisher=American Psychiatric Pub, Inc. |isbn=1585622397 }}</ref>
-Other signs include persistent [[hypertension]] (due to cortisol's enhancement of [[epinephrine]]'s vasoconstrictive effect) and [[insulin resistance]] (especially common in [[ectopic]] ACTH production), leading to [[hyperglycemia]] (high [[blood sugar]]s) which can lead to [[diabetes mellitus]]. Untreated Cushing's syndrome can lead to [[heart disease]] and increased [[death|mortality]]. Cushing's syndrome due to excess [[ACTH]] may also result in hyperpigmentation. This is due to Melanocyte-Stimulating Hormone production as a byproduct of ACTH synthesis from Proopiomelanocortin (POMC). Cortisol can also exhibit [[mineralcorticoid]] activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion). Furthermore, [[gastrointestinal]] disturbances, opportunistic infections and impaired wound healing (cortisol is a stress hormone, so it depresses the immune and inflammatory responses). Osteoporosis is also problem in Cushing's Syndrome, as mentioned before, cortisol evokes a stress-like response. The body's maintenance of bone (and other tissues) is therefore no longer one of its main priorities, so to speak.
+Furthermore, [[gastrointestinal]] disturbances, opportunistic infections and impaired wound healing (cortisol is a stress hormone, so it depresses the immune and inflammatory responses).
-'''Moon face''' is a medical sign where the face swells up into a rounded shape. It is often associated with [[Cushing's syndrome]], which has led to it being known as '''Cushingoid facies''' ("Cushings-like face"), or [[steroid]] treatment, which has led to the name '''steroid facies'''.
+[[Osteoporosis]] is also problem in Cushing's Syndrome, as mentioned before, cortisol evokes a stress-like response. The body's maintenance of bone (and other tissues) is therefore no longer one of its main priorities, so to speak.
 ==References==