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•	Cushing syndrome
•	Tumor
•	Hyperplasia
•	Carbohydrates
•	Fat
•	Protein in diet
•	Diabetes
•	Broken bone
•	Kidney stones
•	Psychosis

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Cushing’s disease

Definition

Cushing’s disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ATCH). The pituitary gland is an organ of the endocrine system.

Cushing's disease is a form of Cushing syndrome.

Alternative Names

Pituitary Cushing's disease

Causes

Cushing's disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. This gland is located at the base of the brain.

People with Cushing's disease have too much ACTH. ACTH stimulates the production and release of cortisol, a stress hormone. Too much ACTH means too much cortisol.

Cortisol is normally released during stressful situations. It controls the body's use of carbohydrates, fats, and proteins and also helps reduce the immune system's response to swelling (inflammation).

Symptoms

Abdomen that sticks out and thin arms and legs (central obesity)
Acne or skin infections
Collection of fat on the back of the neck (buffalo hump)
Depression
Diabetes
Easy bruising
Excessive facial hair growth in females
Headache
Impotence
Increased urination
Moon face (round, red, and full)
Osteoporosis
Purple stretch marks on the abdomen, thighs, and breasts
Stopping of menstruation
Weakness
Weight gain

Exams and Tests

Tests are done to confirm there is too much cortisol in the body, then to determine the cause.

These tests confirm too much cortisol:

24-hour urine cortisol
Dexamethasone suppression test (low dose)

These tests determine cause:

Brain MRI
Dexamethasone suppression test (high dose)
Serum ACTH levels
Test of corticotropin-releasing hormone, which acts on the pituitary gland to cause the release of ACTH (CRH test)
Test that measures ACTH levels in the veins that drain the pituitary gland (petrosal sinus sampling)

Treatment

This version of the Encyclopedia has no treatment information. Please discuss any and all treatment options for your condition with your healthcare professional.

Outlook (Prognosis)

Untreated, Cushing's disease can cause severe illness, even death. Removal of the tumor may lead to full recovery, but the tumor can grow back.

Possible Complications

Compression fractures
Diabetes
High blood pressure
Infections
Kidney stones
Psychosis

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of pituitary Cushing's.

If you have had a pituitary tumor removed, call if you have signs of complications, including signs that the tumor has returned.

References

Stewart PM. The adrenal cortex. In: Kronenberg H, Melmed S, Polonsky K, Larsen PR, eds. Williams Textbook of Endocrinology. Philadelphia, Pa: Saunders Elsevier; 2008:chap 14.

Review Date: 3/18/2008
Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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