Pituitary Cushing's disease
Symptoms
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
Signs and tests
Tests are done to confirm there is too much cortisol in the body, then to determine the cause.
These tests confirm too much cortisol:
- 24-hour
urine cortisol -
Dexamethasone suppression test (low dose)
These tests determine cause:
Blood ACTH level Brain MRI - Corticotropin-releasing hormone test, which acts on the pituitary gland to cause the release of ACTH
- Dexamethasone suppression test (high dose)
- Petrosal sinus sampling - measures ACTH levels in the veins that drain the pituitary gland
Previous Section
Next Section
Cushing’s disease 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)
