Cushings syndrome – Ectopic Acth Syndrome

Cushings syndrome or ectopic Acth syndrome an adrenal disorder caused by excess production of cortisol by the adrenal cortex (outer glands) due to a pituitary tumor.

Cushings syndrome can be characterized by central body obesity, hypertension, glucose intolerance, excess hair growth, osteoporosis, kidney stones, menstrual irregularity and emotional liability, blood analysis show decreased serum K; an Acth dependent syndrome.

Regulation of cortisol production by pituitary Acth (adreno corticotropic hormone)

Causes of cortisol overproduction

(1)– Pituitary tumor, accounts for about 60% of cases.

(2)– Adrenal tumor:

• Adrenal adenoma, accounts for 20-25% of cases.
• Adrenal carcinoma, accounts for about 10% of all cases, letrogenic steroids.

(3)– Acth produced outside of the pituitary, like in lung cancers, it  accounts for 5% of cases.

(1) Its termed Cushing’s disease, serum cortisol and Acth both increased

(2) Increased serum cortisol will decrease Acth Production

(3) Acth produced outside of the pituitary.

Testing and Diagnosis

The amount of cortisol in blood during a 24 hrs period greater than 100 micrograms

Dexamethasone suppression test, to test cortisol secretion after shutting down steroid production in the adrenal gland, it will clear whether the case is Acth dependent or not.

CT scan or MRI imaging of the adrenal glands to explore for adrenal tumors, if a tumor of pituitary origins is suspected, then CT and MRI of the brain and chest must be made.

>>>How to diagnose Cushing’s Syndrome<<<

Treatment

Treatment by surgical removal of the tumor and radiation therapy of the pituitary.

Laparoscopic adrenalectomy is performed if diagnostics show a well defined small tumor.

>>>How to treat Cushing’s Disease<<<

 

all about cushings syndrome

Verified by: Dr.Diab (January 7, 2017)

Citation: Dr.Diab. (January 7, 2017). All you need to know about cushing’s syndrome. Medcoi Journal of Medicine, 10(2). urn:medcoi:article4164.