Hypercortisolism ( Cushing's disease) : Causes, Symptoms , Treatment
hypercortisolism (Cushing's disease) is a pathological condition that arises due to the fact that a large amount of the adrenal gland hormone cortisol, this can happen due to the fact that the person for a long time treated with glucocorticoids.To diagnose hypercortisolism, it is necessary to conduct a sample dexamethasone suppression, CT, scintigraphy and MRI.Treatment will depend on the cause of the disease, you may need to cancel glucocorticoid drugs, inhibitors of steroidogenesis and adrenal surgery is required.
causes of hypercortisolism (Cushing's disease)
This disease occurs due to the fact that increases the secretion of pituitary microadenomas, which is a benign tumor zhelizistoy and produced with the help of adrenocorticotropic hormone.
hypercortisolism most often occurs due to the fact that the adrenal cortex is affected, because there are hyperplastic tumor formation - adenomatosis, adenoma and adenocarcinoma.
also Cushing's disease is caused by a tumor of the testes, thymus, thyroid, prostate, pancreas, lung, ovary, parathyroid gland.
Often, the disease occurs because of receiving glucocorticoids, which are used for the treatment of systemic diseases.
Because cortisol hypersecretion can occur in the decay of muscle, bone structure, skin, internal organs, this leads to that the atrophied tissue.When the disease
amplified gluconeogenesis and glucose absorbed in the intestine, it leads to the development of diabetes steroid form.Due to the fact that disrupted fat metabolism, fat can be debugged in one area of the body.
Excess cortisol detrimental effect on the kidneys, so it can pojavljatsja hyperkalemia, hypernatremia, because of this increased blood pressure and exacerbated by degenerative processes in the muscle.
most at hypercorticoidism suffering heart, because of this there is a cardiomyopathy, heart failure and arrhythmia.At the same time, cortisol can depress the immune system, and people with the disease Cushing's prone to infectious diseases.
for Cushing characterized by mild, moderate and severe.
Symptoms of Cushing's disease
One with pronounced symptoms is obesity, which occurs in 90% of patients.Redistributed fat unevenly, deposits can be seen on the chest, back, face, abdomen, neck.When a person finds hypercorticoidism lunate shape and red-purple color and a cyanotic shade.Due to the fact that fat is being debugged in the cervical spine may occur buffalo hump.you will notice the transparent skin on the back of his hand.
Often hypercorticoidism atrophied muscles, reduces their tone and musculature, because of this, there is a weakness in them.When the disease is reduced volume in the thigh and buttock muscles, gipotrofiruyutsya abdominal muscles, can occur hernia.
skin in patients with different shade of marble, visible vascular pattern, and the skin is badly dry, scaly, some sites are much sweat.
on the shoulder girdle, abdomen, buttocks, hips, breasts can be formed stretch marks that have a purple coloring.It is also often possible to notice a rash on the skin, bleeding under the skin, some parts are subject to hyperpigmentation.
Because Cushing thinner and damaged bone tissue, osteoporosis occurs, which leads to severe pain, bone fractures, scoliosis, it is pronounced in the department of waist and chest.Patient because of this slouching and poor is growing.
Children who suffer illness Itsengo-Cushing, stunted.
affect the disease and on the nervous system, it is defective works, inhibited state, euphoria, depression, suicide attempts, steroid psychosis.
may occur and swelling in women disturbed menstrual cycle, amenorrhea, resulting in infertility.
Men atrophied testicles, decreased libido and potency.
What complications can have hypercortisolism?
If the disease becomes chronic, it leads to the patient's death, because he has symptoms occur that are incompatible with life - stroke, sepsis, severe pyelonephritis, renal failure, crisis adrenal gland, due to which the mind is disturbed, there is hypotension,vomiting, acidosis.
Due to the fact that one can not fight against infectious diseases, he is suffering from boils, cellulitis, suppurative and fungal diseases of the skin.
Diagnosing Cushing's disease
If a patient is suspected of the disease, it is required to be appointed by the test screenings, with which you can determine how much Cortisol in daily urine, if it increased it indicates Cushing's disease.
With dexamethasone samples can also diagnose the disease.To determine the source of Cushing, you need an MRI and CT scan of the pituitary, adrenal scintigraphy.
To diagnose Cushing complications - osteoporosis, fracture of the ribs, etc., it is necessary to carry out an X-ray and CT scan of the chest.Using biochemical analysis of blood may be time to diagnose diabetes steroid nature.
Treatment of Cushing
If the disease has arisen because of the medication, an urgent need to stop the drug or replace it with another.
In cases of endogenous Cushing's character to assign agents to help prevent steroidogenesis.
When a person discover nadopochechnikov tumor, lung or pituitary surgery is necessary.
If not treated in time, it leads to death of the patient.When adrenal insufficiency chronic nature, it is necessary to spend replacement therapy with glucocorticoids and mineralocorticoids.
So hypercortisolism (Cushing's disease) is very important time to diagnose, treat, identify the cause of its occurrence and the degree of complications.Patients with this disease should always be seen by an endocrinologist, they are prohibited heavy exercise.