The symptoms (fatigue) and clinical signs (full face, fat accumulation in the abdomen, muscle weakness on standing, brittle skin, bruising and skin discolouration) in Cushing's syndrome are the result of long-term exposure to high doses of cortisone (glucocorticoids). The major cause of this syndrome is the long-term use of high doses of cortisone (e.g. Medrol/prednisolone for lung disease, rheumatism, chemotherapy). This is what we call an iatrogenic form of Cushing’s syndrome.
The condition in which the adrenal glands are stimulated from the pituitary gland (by a pituitary adenoma) to produce extra cortisone is known as Cushing’s disease. Other tumours (e.g. lung tumours) can also stimulate the adrenal glands to produce extra cortisone. Benign and malignant tumours of the adrenal gland itself can, in rare cases, cause excessive cortisone production.
If you suspect this, please contact your GP. Bring the results of any examinations with you to the endocrinology consultation. You are not required to fast. An additional blood test, 24-hour urine collection and dexamethasone suppression test (in the context of confirming the abnormality) and/or other tests (to determine the cause of excessive cortisol production) may also be performed, e.g. CT adrenal glands, CT lungs, etc. After the diagnosis, we will determine, together with you, the further policy (e.g. phasing out or/and looking for an alternative to Medrol, treating the causative tumour, etc.).
Your doctor will discuss the treatment options with you.
