Cushing's syndrome - Signs and symptoms, Diagnosis, Pathophysiology, Treatment, Epidemiology, Hyperadrenocorticism in Companion Animals

A disorder caused by excessive levels of glucocorticoid hormones. It may be a result of steroid treatment, or excessive secretion of glucocorticoids by the adrenal glands, due to a benign adrenal tumour or overstimulation of the adrenal glands by hormones secreted by the pituitary gland. It produces a range of characteristic clinical features, including a round red face, thin easily bruised skin, obesity, muscle wasting, osteoporosis, amenorrhoea, and hypertension.

Cushing's syndrome
Classifications and external resources

Cortisol
ICD-10	E24.
ICD-9	255.0
DiseasesDB	3242
MedlinePlus	000410
eMedicine	med/485

Cushing's syndrome or hypercortisolism or hyperadrenocorticism is an endocrine disorder caused by excessive levels of the endogenous corticosteroid hormone cortisol.

Cushing's syndrome is also a relatively common condition in domestic dogs in which causes are the same as the syndrome in humans.

Signs and symptoms

Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity), "moon face", excess sweating, telangiectasia (dilation of capillaries), atrophy of the skin (which gets thin and bruises easily) and other mucous membranes, purple or red striae on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders), and hirsutism (facial male-pattern hair growth). Untreated Cushing's syndrome can lead to heart disease and increased mortality. Cushing's syndrome due to excess ACTH may also result in hyperpigmentation of the skin, due to its ability to stimulate melanocyte receptors.

Diagnosis

When Cushing's is suspected, a dexamethasone suppression test (administration of dexamethasone and frequent determination of cortisol and ACTH levels) and 24-hour urinary measurement for cortisol have equal detection rates (Raff &

When these tests are positive, CT scanning of the adrenal gland and MRI of the pituitary gland are performed.

Pathophysiology

Cortisol is secreted by the adrenal glands under regulation by the pituitary gland and hypothalamus.

Treatment

If an adrenal adenoma is identified it may be removed by surgery.

Removal of the adrenals in the absence of a known tumor is occasionally performed to eliminate the production of excess cortisol.

In iatrogenic Cushing's, dose adjustment may be sufficient or it may be necessary to change to another type of immunosuppresive medication.

Epidemiology

Iatrogenic Cushing's syndrome (caused by treatment with corticosteroids) is the most common form of Cushing's syndrome. non-iatrogenic) Cushing's syndrome is relatively rare.

Incidence of causes of Cushing's syndrome per million person-years:

Cushing's disease: 10 Primary adrenal: 3 Ectopic ACTH: 1.4

Hyperadrenocorticism in Companion Animals

Hyperadrenalcorticism is an important disease in domestic dogs and domestic ferrets. Dogs with pituitary-dependent Cushing's syndrome may be treated by radiation therapy directed against a pituitary adenoma. Latest information regarding the diagnosis, treatment (conventional/complementary), and long-term management of Cushing's syndrome (PDH, ADH, Iatrogenic, Atypical). Cushing Hunde
German-speaking support group for owners of dogs with Cushing's syndrome. Cushing's Syndrome/Disease in dogs Equine Cushing's and Insulin Resistance Equine Metabolic Syndrome Ferret Health List Insulinoma Adrenal Ferrets