It is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year. Cushing's was discovered by American physician, surgeon and endocrinologist Harvey Cushing (1869-1939) and reported by him in 1932.
Cushing's Disease is caused by an excessive secretion of adrenocorticotropic hormone (ACTH) which is produced by a pituitary tumor. The ACTH then triggers your adrenal glands (which sit on your kidneys) to produce excess amounts of glucocorticoids (Cortisol). In most cases the pituitary tumor is a microadenoma (10mm or less). It is fairly uncommon to have a macroadenoma, but if you do have one it can cause optic nerve compression, bone erosion and sinus compression. This can cause headaches/migraines, vision impairements and other painful symptoms. Cushing's Disease is more common in females than males at a 5:1 ratio. It is more common for it to develop in women at the reproductive age but can occur at any age.
Symptoms vary, but most often involve upper body obesity, round full face also known as "moon face", increased fat around the neck (buffalo hump), and thinning of arms and legs. Other symptoms occurring in Cushing's disease are best described as an accelerated aging of the body: skin becomes fragile, thin, bruises easily and heals poorly, along with purplish pink stretch marks appearing on the abdomen, thighs, buttocks, arms and breasts; the bones are weakened (osteoporosis); severe fatigue, muscle weakness, irritability, anxiety and depression are common; high blood pressure (hypertension) and high blood sugar (diabetes) often occur.Direct pressure by an enlarging pituitary adenoma in Cushing's disease can affect the surrounding critical neurovascular structures. Optic nerves may be affected as a result of direct pressure by the tumor leading to visual field defects (mainly in peripheral vision). There are many other symptoms of Cushing's disease and each patient's symptoms vary. Children, tend to be obese with slowed growth rates. Women usually have excess hair growth on their faces, necks, chests, abdomens, thighs and their menstrual periods may become irregular or stop. Men, have decreased fertility with diminished or absent sexual desire.
Diagnosis: The evaluation of a patient with suspected Cushing's disease is complex and requires a number of tests which are necessary to diagnose and confirm Cushing's disease. An important screening test for Cushing's disease is the 24-hour urine collection with analysis for urinary free cortisol excretion. Low-dose and high-dose dexamethasone suppression tests, corticotropin assays, and a corticotropin-releasing hormone (CRH) stimulation test may also be used. Blood samples are obtained and measured for ACTH . Ultrasound examination can be performed to exclude or to determine if the primary cause of Cushing's syndrome is an adrenal gland tumor.Radiological evaluation of the pituitary by magnetic resonanace imaging (MRI), with and without intravenous contrast, is useful in localizing the lesion and determining its size and invasiveness.
I realize that some of this may sound really complicated or may be difficult to understand.I have explained it the best way that I can but if you have any questions feel free to ask!
Stacy - great job on the explanation. I am so glad you are doing this...keep up the good work. Also it would be great to see your picture on the blog so we can see how gorgeous you are.
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