Cushing’s Disease, Research Paper Example

Statistics:  Most of the Cushing’s disease patients are between the ages of 20 and 50. The disease is a lot more common amongst women as compare to men; the ratio is estimated to be about 5:1 (Novartis Pharmaceuticals Corporation).

Etiology: Adrenal glands produce a number of hormones of which one is cortisol. Cortisol performs numerous functions in the human body including regulating blood pressure, keeping cardiovascular system functioning normally, and helping in the metabolism processes such as converting proteins, carbohydrates, and fats into usable energy.

Overproduction of cortisol results in Cushing’s syndrome which could be due to either internal or external factors. External factors include taking corticosteroid medications in high doses over a long period of time and injectable corticosteroids in high doses. Internal factors include excess production of cortisol by one or both adrenal glands or overproduction of the adrenocorticotropic hormone (ACTH) which regulates cortisol production. This overproduction of the ACTH is what causes Cushing’s disease (Mayo Clinic).

Symptoms: Symptoms for Cushing’s disease include changes in weight, skin, mental state, muscles and bones, and sex hormones. The patient may have round or puffy face, increased fat around the neck or upper part of the back, or an enlarged waistline. Sin changes include easily bruised skin, slow-healing wounds, acne, and purplish stretch marks on the body. Changes in mental state include irritability, anxiety, insomnia, and depression. Changes in muscles and bones include backache, broken bones, and loss of muscle tone and strength. Sex hormone changes include menstrual irregularity, loss of sex drive, and erectile dysfunction. Other symptoms are high blood pressure and diabetes. Women may also have more visible body and face hair.  Patient’s field of vision can also be affected. A patient may have loss of side, or peripheral vision. (WebMD).

Diagnosis: The doctor may start with a physical exam to look for symptoms of the Cushing’s disease. If a patient has been taking corticosteroid medications for a long time, this may be a reason to suspect Cushing’s syndrome. Otherwise, the doctor may carry other tests such as urine and blood tests, saliva test, and imaging tests such as CT scans or MRI scans of pituitary and adrenal glands to detect abnormalities (Mayo Clinic).

Treatment: The doctor may recommend surgery to surgically remove the tumor. Neurosurgeon may perform the procedure through the nose to remove pituitary tumor. A tumor in the adrenal gland, lungs, or pancreas could be removed through a standard operation or sometimes through minimally invasive surgical techniques with smaller incisions. But if the surgeon can’t totally remove a pituitary tumor, he may prescribe radiation therapy in conjunction with the operation. Radiation may also be a stand-alone substitute for candidates not suitable for surgery. But when surgery and radiation don’t work, medications could be used to control cortisol production (Mayo Clinic).

Prognosis: Removing the tumor may lead to full recovery but the probability of remission remains. Pituitary irradiation can induce remission of disease in more than half of the patients with recurrence after surgery. Patients who are not cured may require total bilateral adrenalectomyms. Patients who have been surgically treated for Cushing’s disease require long-term follow-up and monitoring. The pituitary adrenal axis must be evaluated 6 to 12 months after surgery to determine the potential need for lifetime exogenous steroid replacement therapy (Kirk Jr., Hash and Katner).

References

Kirk Jr., Lawrence F., et al. Cushing’s Disease: Clinical Manifestations and Diagnostic Evaluation. September 2000. 26 December 2011 <http://www.aafp.org/afp/2000/0901/p1119.html>.

Mayo Clinic. Cushing’s syndrome: Causes. 26 December 2011 <http://www.mayoclinic.com/health/cushings-syndrome/DS00470/DSECTION=causes>.

—. Cushing’s syndrome: Test and diagnosis. 26 December 2011 <http://www.mayoclinic.com/health/cushings-syndrome/DS00470/DSECTION=tests-and-diagnosis>.

—. Cushing’s syndrome: Treatments and drugs. 26 December 2011 <http://www.mayoclinic.com/health/cushings-syndrome/DS00470/DSECTION=treatments-and-drugs>.

Novartis Pharmaceuticals Corporation. Cushing’s disease. 26 December 2011 <http://www.cushingsdisease.com/patient/your-disease/facts.jsp>.

WebMD. Cushing’s Syndrome. 26 December 2011 <http://www.webmd.com/a-to-z-guides/cushings-syndrome-symptoms>.