Patients with pituitary-dependent Cushing’s syndrome with adrenal hyperplasia and severe cushingoid symptoms (such as psychosis, poorly controlled diabetes mellitus, osteoporosis, and severe pathologic fractures) may require pituitary irradiation.įollowing the prescribed drug therapy could necessitate recovery. Treatment to restore hormonal balance and reverse Cushing’s syndrome may necessitate radiation, drug therapy, or surgery. Indicators of Cushing’s syndrome include an increase in the blood glucose levels, a reduction in the number of eosinophils, and disappearance of lymphoid tissue. A patient with Cushing’s syndrome include an increase in serum sodium and a decrease in potassium levels. Ultrasound, CT scan, or angiography localizes adrenal tumors and may identify pituitary tumors. In a stimulation test, administration of metyrapone, which blocks cortisol production by the adrenal glands, tests the ability of the pituitary gland and hypothalamus to detect and correct low levels of plasma cortisol by increasing corticotropin production. Dexamethasone (1 mg) is administered orally at 11pm, and a plasma cortisol level is obtained at 8am the next morning, and this usually confirms the diagnosis of Cushing’s syndrome. Low-dose dexamethasone suppression test.To detect Cushing’s syndrome, the following are performed: The nurse assesses fluid and electrolyte status by monitoring laboratory values and daily weights. Adverse effects of adrenocortical activity.The patient with Cushing’s syndrome whose symptoms are treated by withdrawal of corticosteroids, by adrenalectomy, or by removal of a pituitary tumor is at risk for adrenal hypofunction and addisonian crisis. Increased susceptibility to infection due to decreased lymphocyte production and suppressed antibody formation.Ĭomplications of Cushing’s syndrome include the following: Hypertension occurs due to sodium and water retention. Irritability and emotional lability ranges from euphoric behavior to depression and psychosis. Peptic ulcer results from increased gastric production and pepsin secretion, and decreased gastric mucus. Fat pads throughout the trunk refers to truncal obesity, one of the symptoms in Cushing’ triad Moon face is a symptom included in the Cushing’s triad and are recognized as excess fats over the face. Buffalo hump is one of the symptoms included in the Cushing’s triad, and these are fat pads over the upper back. Muscle weakness is due to hypokalemia or a loss of muscle mass from increased catabolism. Like other endocrine disorders, Cushing’s syndrome induces changes in multiple body systems, depending on the adrenocortical hormone involved. In the remaining 30% of the patients, Cushing’s syndrome results from a cortisol-secreting adrenal tumor, which is usually benign. In approximately 70% of patients, Cushing’s syndrome results from excessive production of corticotropin and consequent hyperplasia of the adrenal cortex. It is more common in women than in men and occurs primarily between ages 25 and 40.Ĭauses of Cushing’s syndrome include the following:.Cushing’s syndrome affects 13 of every 1 million people.
Incidences of Cushing syndrome are already common worldwide.
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