adrenocorticotropic hormone ACTH-dependent Cushing's syndrome

adrenocorticotropic hormone ACTH-independent Cushing's syndrome

Other types of Cushing's syndrome - iatrogenic - long-term use of larger doses of exogenous glucocorticoids

Central obesity, moon face, sanguine appearance: Central obesity - head and face, back of neck, supraclavicular fossa, abdomen. The face is round and dark red. Characteristic moon face, buffalo back, hanging belly.

Skin manifestations: thin skin, rosy complexion. Bloody face. Both sides of the lower abdomen, outer thighs, buttocks - purple-red stripes. Frequent bleeding and fungal infection around the anus of hands and toes.

Metabolic disorders: increased sugar. Enhanced gluconeogenesis, antagonizing insulin to lower blood sugar. Steroid diabetes. Marked hypokalemic intoxication is seen in adrenocortical carcinoma. Mild edema. Osteoporosis occurs in older people with the disease.

Cardiovascular manifestations: hypertension. arteriosclerosis, venous thrombosis

Weakened resistance to infection: Pulmonary infections are common and can easily develop into cellulitis, bacteremia, and sepsis.

Changes in sexual function: Acne and hairiness in women, oligomenorrhea or even amenorrhea. If virilization occurs - clitoromegaly - adrenocortical cancer.

Whole body and nervous system: Muscle atrophy of limbs, often manifested as muscle weakness. Difficulty standing up after squatting

Cortisol measurement

dexamethasone suppression test

ACTH stimulation test - both pituitary and ectopic ACTH respond.

Imaging - CT for the adrenal gland and MRI for the pituitary gland

Cushing's disease: transsphenoidal adenoma resection is preferred. Pituitary macroadenoma - craniotomy. Cyproheptadine, bromocriptine.

Adrenal adenoma—laparoscopic removal. Cortisone – Replacement therapy can be gradually discontinued from 6 months to 1

Nodular (large and small) bilateral adrenalectomy and postoperative hormone replacement therapy

Ectopic ACTH syndrome—mitotane, ketoconazole.

body image disorder

Too much body fluid

Risk of infection

Potential complications: fracture

Potential complications: heart failure, stroke, steroid-induced diabetes

Adverse drug reactions, etc.

Discontinuation of hormones at will - adrenal crisis - weakness, dizziness, fever, nausea and vomiting