Research Paper on What is Cushing's Syndrome?

Introduction

The name Cushing's syndrome came after a famous neurosurgeon and pathologist, Harvey Cushing who first gave its description. The presence of excessive cortisol or steroids in one's blood has been known to cause Cushing's syndrome (Nieman et al.). Cortisol is produced by the adrenal glands which also play an essential role in response to stress. It is of great benefit to note that normal levels of cortisol are significant for not only for life sustenance but also the maintenance of normal sleep cycles so that the body can cope well with stressful life events. While limited cortisol levels are considered normal, its long-term increment to higher levels in the body poses harm to the organ systems - individuals taking too many steroids as a form of medication risk developing Cushing's syndrome. Also, when a person's body produces too much steroid, then the person can develop Cushing's syndrome. This condition can also come by if a person takes high doses of medications similar to cortisol for an extended period to treat inflammatory diseases like asthma, rheumatoid arthritis, or even inflammatory bowel disease. In fact, this comes out as the common cause of Cushing's disease and is known as "iatrogenic" as it is caused by the doctor. Particular medications that are similar to cortisol are known as corticosteroids or glucocorticoids, but people refer to them as steroids ("Cushing Syndrome - Symptoms And Causes"). These are different from the variety that athletes take to enhance performance. There are three major sources of cortisol in the body: the pituitary source, adrenal source, and the other "ectopic" source. For the pituitary source, the pituitary gland secrets excess adrenocorticotropic hormone (ACTH) which controls the activities of the adrenal glands. After this, the signal transmitted by the ACTH moves through the bloodstream and consequently causes adrenal glands to make too much cortisol. Pituitary tumors are known to cause 70% of cases of Cushing's syndrome (Raff et al.). When ACTH originates from the pituitary gland, the condition is known as Cushing's disease and not Cushing's syndrome. For the adrenal source, a specific tumor in one of the adrenal glands ends up producing surplus amounts of cortisol. In this case, the pituitary gland is normal because the adrenal tumor is acting alone; this often results in about 30% of Cushing syndrome cases. For the other ectopic source, which is very rare, accounts for as less as less than 1 percent of cases of Cushing syndrome. What this means is that a tumor on the outside of the pituitary gland makes a lot of ACTH, and the ectopic ACTH-producing tumor is mostly found in the thymus and the lung all of which are around the chest area (Nieman et al.).

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

What Is Ectopic Adrenocorticotropic Hormone (ACTH) And How Does It Occur?

As has been discussed, Cushing syndrome can also be caused by the production of ectopic adrenocorticotropic hormone. This cause of Cushing's disease is infrequent and has been noted, and a few cases have been reported in children. In fact, some research indicates that ectopic ACTH-secreting tumors are sporadic in children and young adults. Cushing syndrome is complicated to diagnose as cases studied have always led to erroneous diagnoses. Due to false assumptions of Cushing's syndrome, some patients have been subjected unnecessary TSS because the secretion of Corticotropin-releasing hormone stimulates the pituitary gland to cause hyperplasia. Localization of the tumor that secrets ectopic ACTH/CRH is thus a challenging process. While some patients have abdominal tumors especially in the pancreas and liver, other tumors are localized in the chest areas like the thymus and the lungs. Imaging studies, in particular cases, like octreotide, CT scans, and special biochemical tests have been performed to detect the tumors. Because most hospitals do not have the invasive techniques, imaging, and biochemical techniques to employ, plus the rarity of the ectopic ACTH or CRH-producing tumors, they often go for the TSS. Also, of importance to note as far as the biochemical features of this particular kind of ectopic Cushing's disease is concerned, is that most findings are strongly dependent on the ratio at which ACTH and CRH are secreted (Nieman et al.). It should not be forgotten that ectopic Cushing syndrome is also caused when ACTH hormone is produced somewhere that is not the pituitary gland. The tumors that cause this form of Cushing syndrome by releasing ACTH are rare, and this is why this condition is also limited. Such tumors include the islet cell tumors, the medullary carcinoma located in the thyroid, cell tumors of the lungs, benign carcinoid tumors and the tumors of the thymus gland. While the ACTH is so much involved, it is still not yet clear what causes ACTH-secreting tumors. Women between the ages 30 and 40 years old have been commonly diagnosed with this condition even though it is now clear it can affect all people of all ages. Apparently, the majority of ACRH-secreting tumors are not cancerous but benign, but in certain rare cases, they can potentially become cancerous (Coe et al.).

Physiological Changes in the Body of a Person with Cushing Syndrome versus One Without

It is challenging to explicitly pinpoint the symptoms of Cushing's disease considering the similarities they have with other diseases. Even if that is the case, any treatment should begin by spotting specific signs and symptoms before beginning the clinical diagnosis and then later treatment of the condition. Opposite to what is expected of the normal person, most patients with Cushing's disease experience sudden weight gain that is evenly distributed. Other symptoms include the thickening of the facial fat, and due to telangiectasias, the face assumes a florid complexion. Individuals with this condition develop massive dorsocervical fat pat also known as "buffalo hump"; signs which are not typically observed in people without Cushing's disease. Other related conditions include glucose intolerance, hypertension, and amenorrhea that is observed in menopausal women. Men experience decreased libido as well as sudden ecchymoses. It is easy to observe that individuals with this disease have an accumulation of fat in the abdominal regions and the rear sections of the neck. While the abdominal area may remain round, the patients often retain thin legs and arms. Other physical changes include purple stretch marks also known as abdominal striae, and, these individuals tend to bruise easily. These symptoms are not commonly observed with ordinary people without Cushing's disease (Raff et al.).

Conclusion

In conclusion, Cushing's disease is caused by increased amounts of cortisol or steroids in the blood. Cortisol is produced from three sources in the human body and can also be found from medications such as steroids - the secretion of adrenocorticotropic hormone (ACTH) from the pituitary glands and influences the production of cortisol. The production of ectopic Adrenocorticotropic Hormone can also result in the cause of Cushing's disease. The symptoms are not easy to notice without a little confusion. Weight gain, round fatty face, development of buffalo hump, change of skin complexion and loss of libido, among many others, are some of the physical signs of Cushing's disease.

Works Cited

Coe, Susan G. et al. "Cushing'S Syndrome Due To Ectopic Adrenocorticotropic Hormone Production Secondary To Hepatic Carcinoid: Diagnosis, Treatment, And Improved Quality Of Life". Journal Of General Internal Medicine, vol 23, no. 6, 2008, pp. 875-878. Springer Nature, doi:10.1007/s11606-008-0587-z. Accessed 11 Dec 2018.

"Cushing Syndrome - Symptoms And Causes". Mayo Clinic, 2018, https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310. Accessed 11 Dec 2018.

Nieman, Lynnette K. et al. "The Diagnosis Of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline". The Journal Of Clinical Endocrinology & Metabolism, vol 93, no. 5, 2008, pp. 1526-1540. The Endocrine Society, doi:10.1210/jc.2008-0125. Accessed 11 Dec 2018.

Raff, Hershel et al. "Physiological Basis For The Etiology, Diagnosis, And Treatment Of Adrenal Disorders: Cushing's Syndrome, Adrenal Insufficiency, And Congenital Adrenal Hyperplasia". Comprehensive Physiology, 2014, pp. 739-769. John Wiley & Sons, Inc., doi:10.1002/cphy.c130035. Accessed 11 Dec 2018.