Hormones & metabolismHormonalICD-10 E24
Cushing's syndrome
Prolonged excess of the stress hormone cortisol, most often from steroid medicines, causing weight gain in the trunk and face, thin skin, muscle weakness and high blood pressure.
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Causes
- Long-term steroid medication (most common)
- Pituitary tumour secreting ACTH (Cushing's disease)
- Adrenal tumour
- Ectopic ACTH from lung tumours
Risk factors
- High-dose long-term glucocorticoids
Symptoms
- Central obesity, rounded face, fat pad at the back of the neck
- Purple stretch marks
- Easy bruising
- Muscle weakness
- High blood pressure and diabetes
- Mood changes
Diagnosis — tests and examinations
- Overnight dexamethasone suppression test
- 24-hour urinary cortisol, late-night salivary cortisol
- ACTH level and imaging to locate the cause
Treatment
Medicines and medical treatment
- Taper steroid medicines if possible
- Cortisol-lowering drugs (metyrapone, osilodrostat)
Operations and procedures
- Transsphenoidal pituitary surgery
- Adrenalectomy
- Radiotherapy
Self-care, home remedies and lifestyle
- Never stop long-term steroids suddenly
Possible complications
- Diabetes
- Osteoporosis
- Infections
- Cardiovascular disease
Prevention
- Using the lowest effective steroid dose
Outlook
Usually good after treating the cause.
When to see a doctor
See a doctor for rapid weight gain with purple stretch marks and high blood pressure.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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