Cushing syndrome - corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndrome; Exogenous Cushing syndrome

Symptoms usually include:

• Upper body obesity (above the waist) and thin arms and legs
• Round, red, full face (moon face)
• Slow growth rate in children

Skin changes that are often seen:

• Acne or skin infections
• Purple marks (1/2 inch or more wide), called striae, on the skin of the abdomen, thighs, and breasts
• Thin skin with easy bruising

Muscle and bone changes include:

• Backache, which occurs with routine activities
• Bone pain or tenderness
• Collection of fat between the shoulders (buffalo hump)
• Thinning of the bones, which leads to rib and spine fractures
• Weak muscles

Women often have:

• Excess hair growth on the face, neck, chest, abdomen, and thighs
• Menstrual cycle becomes irregular or stops

Men may have:

• Decreased fertility
• Decreased or no desire for sex
• Impotence

Other symptoms that may occur include:

• Mental changes, such as depression, anxiety, or changes in behavior
• Fatigue
• Headache
• High blood pressure
• Increased thirst and urination

In people who use cortisone, prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:

• Low ACTH level
• Low cortisol level
• No response to a cosyntropin stimulation test
• Higher than normal fasting glucose
• Low blood potassium level
• Low bone density, as measured by dual x-ray absorptiometry (DEXA)
• High cholesterol, particularly high triglycerides and low high-density lipoprotein (HDL)

A method called high performance liquid chromatography (HPLC) can show high levels of the suspected medication in the urine.

Images

Hypothalamus hormone production

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Cushing syndrome Overview

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Cushing syndrome Treatment

Review Date: 11/23/2009
Reviewed By: Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)