What is Cushing's syndrome

Cushing's syndrome Cushing's syndrome caused by excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland is specifically called Cushing's disease. This is an uncommon but extremely influential disease, and it is a type of tumor cancer. We certainly don’t know much about this, so let me explain it to you below so that you can have a brief understanding of it together and be prepared for any eventuality.

Causes ① ACTH-dependent Cushing's syndrome, including Cushing's disease and ectopic ACTH secretion syndrome. The former accounts for about 70% of Cushing's syndrome. 80% of patients have microadenomas in the pituitary gland, which secrete excessive ACTH and cause bilateral adrenal cortical hyperplasia. In addition, some ectopic tumors can secrete ACTH-releasing hormone and can also cause ACTH-dependent Cushing's syndrome. ② ACTH-independent Cushing's syndrome is mainly caused by adrenal cortical adenoma and adenocarcinoma and is the second cause of Cushing's syndrome. In addition, long-term, excessive use of glucocorticoids and alcoholism can also cause non-ACTH-dependent Cushing's syndrome.

Clinical manifestations

① Obesity and purple stretch marks. Excessive cortisol causes abnormal fat distribution and excessive protein decomposition. Most patients have centripetal obesity, a full moon face, and thin and weak limbs. The skin is thin and prone to bruising, and purple lines form due to the rupture of the skin's elastic fibers. Osteoporosis and pathological fractures are common. ② Abnormal blood pressure and metabolism. Patients often have hypertension, hypokalemia, alkali poisoning and glucose metabolism disorders. The incidence of diabetes and impaired glucose tolerance in Cushing's syndrome is about 20% each. ③ Abnormal gonadal function. The growth and development of those who develop the disease in childhood may be affected, and adult patients often have decreased sexual desire. Female patients often have menstrual disorders and amenorrhea, partly because adrenal cortical carcinoma secretes a large amount of adrenal cortical androgen, resulting in hirsutism and masculinization; male patients may develop impotence. ④ Psychiatric symptoms, common ones include irritability, depression, and even manifestations of schizophrenia.

Treatment is usually surgery. The radical cure for this disease includes removal of pituitary and ectopic ACTH-secreting tumors, adrenal cortical adenomas or adenocarcinomas, and subtotal adrenalectomy for bilateral hyperplasia. ② Pituitary radiotherapy. 60Co or linear accelerator external pituitary irradiation therapy is commonly used, mostly as an adjuvant therapy for surgery, and has a slow onset of effect. ③Drug treatment. It is used in situations where surgery is not suitable or for postoperative adjuvant treatment. Commonly used drugs include cortisol synthase inhibitors such as mitotane, aminohypnol, and metyrapone, as well as the 5-hydroxytryptamine antagonist cyproheptadine, but the therapeutic effect is not ideal. ④Supportive therapy. Such as correcting hypertension, hypokalemia and sugar metabolism disorders.

This is a difficult disease to treat. In the view of many medical experts at home and abroad, this is a relatively troublesome disease. Of course, physical diseases usually have inducing causes. What we need to do for such diseases is to discover them early so that we can treat them in the early stages and the hope of recovery will be greatly increased.