What is cushing syndrome

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Cushing syndrome occurs when the adrenal cortex becomes more active than necessary. Cushing's syndrome is caused by the effect of excessive corticosteroid medication, secondly by hyperplasia. Excessive production of corticosteroids can lead to many complications. The pitutary t gland secretes ACTH hormone but it releases too much ACTH for hormonal secretions and that too more than required, then this type of condition occurs. Pitutary tumor is also responsible for Cushing syndrome.

Clinical manifestation

• Opthalmic

Cataracts	Glucoma

• Cardiovascular

Hypertension	Heartfailure

• Skeletal

Osteoporosis	Spontaneous fracture
Aseptic necrosis of femur	Vertebral compression fracture

• Gestrointesinal

Peptic Ulcer	Pancreatitis

• Muscular

Myopathy	Muscle weakness

• Dermatologic

Thinning of skin	petechiae	ecchymoses	striae	acne

• Phychiatric

Mood alterations	Psychoses

• Immune function

Decreased inflammatory responses	Impaired would healing	Increased susceptibility to infection

• Endocrine/ Metabolic

Truncal obesity	moon face	buffalo hump
Sodium retention	hypokalemia	metabolic alkalosis
Hyperglycemia	menstrual irregularities	impotence
negative nitrogen balance	altered calcium metbolism	adrenal suppression

Medical menagement

If it is cause by pitutary tumors instead of tumors of the adrenal cortex so treatment is directed at the pitutary glands. Remove glands by surgery which is known as Transsphenoidal hypophysectomy.

If this is a result of administration of corticosteroids, so please tepper dose of medication.

If bilateral adrenalectomy done so we need to replace hormone with oral medication for lifetime.

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