Materiały źródłowe

• #1 Cushing’s syndrome: when cortisol floods the blood – USZ

  https://www.usz.ch/en/disease/cushings-syndrome/

  If too much of the hormone cortisol circulates in your body for a long time, you could develop Cushing’s syndrome. […] Depending on why too much cortisol is circulating in your body, medical experts distinguish between two forms of Cushings syndrome: […] Endogenous Cushings syndrome: In this rarer form, which originates internally, hypercortisolism is usually caused by tumors in the pituitary gland, in the adrenal cortex or, more rarely, by other tumors. […] Exogenous Cushings syndrome: This form caused from outside is the result of drug therapy with glucocorticoids in the form of tablets, injections or infusions. […] Cushings syndrome is always caused by a prolonged excess of cortisol in the body, known as hypercortisolism. […] More often, Cushings syndrome has external causes. This type of exogenous Cushings syndrome is caused by long-term treatment with certain medications:

• #2 Cushing’s Syndrome and Cushing Disease | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/cushings-syndrome-and-cushing-disease

  Cushing syndrome (also sometimes called Cushing’s syndrome) is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time. There are two types of Cushing syndrome: exogenous (caused by factors outside the body) and endogenous (caused by factors within the body). The only difference is the causes. […] A pituitary adenoma is the most common cause of Cushing disease. […] The most common cause of exogenous Cushing syndrome is due to people taking cortisol-like medications such as prednisone. […] Endogenous Cushing syndrome, in which the adrenal glands produce too much cortisol, is uncommon. […] This type of Cushing syndrome is most often caused by hormone-secreting tumors of the adrenal glands or the pituitary, a gland located at the base of the brain.

• #3 Cushing syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000410.htm

  Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol. […] The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. […] Other people develop Cushing syndrome because their body produces too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are: […] Cushing disease, which occurs when the pituitary gland makes too much of the hormone adrenocorticotrophic hormone (ACTH). ACTH then signals the adrenal glands to produce too much cortisol. A pituitary gland tumor can cause this condition. […] Tumor of the adrenal gland […] Tumor elsewhere in the body that produces corticotropin-releasing hormone (CRH) […] Tumor elsewhere in the body that produces ACTH (ectopic Cushing syndrome).

• #4 Endogenous Cushing Syndrome: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/2233083-overview

  Cushing syndrome is caused by prolonged exposure to elevated levels of either endogenous or exogenous glucocorticoids. Exogenous use of glucocorticoids should always be considered and excluded in the etiology of Cushing syndrome. Endogenous glucocorticoid overproduction, or hypercortisolism, can be dependent on or independent of adrenocorticotropic hormone (ACTH). […] The following conditions may cause endogenous glucocorticoid overproduction. […] Overproduction of glucocorticoids may be due to an adrenal adenoma, adrenal carcinoma, or macronodular or micronodular adrenal hyperplasia. […] Ectopic cortisol secretion from a case of ovarian carcinoma has been reported as a cause of ACTH-independent Cushing syndrome. […] ACTH-producing pituitary adenoma. […] Ectopic ACTH secretion is caused by small-cell lung tumors, carcinoid tumors, or other tumors with neuroendocrine origin. These tumors themselves can secrete ACTH, which subsequently stimulates the adrenal glands to make more cortisol.

• #5 Cushing Syndrome: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5497-cushing-syndrome

  Cushing syndrome is a condition caused by too much of the hormone cortisol in the body. The excess may happen because of medications or because your body produces too much of the hormone. […] A tumor typically causes the cortisol levels found in Cushing syndrome. […] Endogenous (from within the body): Cushing syndrome happens because of cortisol produced by your body. […] Exogenous (from outside sources): Cushing syndrome happens because of the side effects of certain medications taken to treat other conditions. […] Too much cortisol causes Cushing syndrome. There may be many underlying causes of high cortisol levels, including: […] Use of glucocorticoid medications. Glucocorticoid medications (for example, prednisone) are used to treat many autoimmune diseases, such as chronic asthma, rheumatoid arthritis, lupus, sarcoidosis and many other diseases that result in chronic inflammation. Chronic treatment with these medications causes iatrogenic or exogenous Cushing syndrome.

• #6 Causes and pathophysiology of Cushing syndrome – UpToDate

  https://www.uptodate.com/contents/causes-and-pathophysiology-of-cushings-syndrome

  Causes and pathophysiology of Cushing syndrome […] The diagnosis of Cushing syndrome involves three steps: suspecting it on the basis of the patient’s symptoms and signs, documenting the presence of hypercortisolism, and determining its cause. The last step requires an understanding of the causes and pathophysiology of the different types of Cushing syndrome; these will be reviewed here (figure 1). […] Cushing syndrome may be caused either by excessive corticotropin (ACTH) production (often called ACTH-dependent Cushing syndrome) or by autonomous adrenal cortisol secretion (often called ACTH-independent Cushing syndrome) (table 1). Approximately 80 percent of endogenous Cushing syndrome cases are ACTH dependent, and approximately 20 percent are ACTH independent (figure 1). […] Among all patients presenting with Cushing syndrome, the most common cause is iatrogenic Cushing due to exogenous administration of glucocorticoids. The second most common form overall is Cushing disease (pituitary hypersecretion of ACTH).

• #6 Causes and pathophysiology of Cushing syndrome – UpToDate

  https://www.uptodate.com/contents/causes-and-pathophysiology-of-cushings-syndrome

  Hypercortisolism can occur in several disorders other than Cushing syndrome. When such patients present with clinical features consistent with Cushing syndrome, they may also be referred to as having physiologic hypercortisolism or pseudo-Cushing syndrome. […] The causes of ACTH-dependent Cushing syndrome are associated with bilateral adrenocortical hyperplasia; their relative frequency is as follows:

• #7 Cushing’s Syndrome (Disease): Symptoms, Causes & Treatment

  https://www.webmd.com/a-to-z-guides/cushing-syndrome

  Cushing’s syndrome is a hormonal disorder caused by high levels of the hormone cortisol in your body. […] You can get Cushing’s syndrome when there’s too much cortisol in your body for too long. […] The most common cause is related to medications called glucocorticoids, also commonly known as corticosteroids or steroids (for example, prednisone). […] Although rare, you can also get Cushing’s syndrome from injectable steroids, such as repeated shots for joint pain, bursitis, and back pain. […] A tumor in your pituitary gland (found at the base of the brain) or a tumor in the adrenal glands can also prompt your body to make too much cortisol, which can lead to Cushing’s. […] In rare cases, an ACTH-secreting tumor causes Cushing’s syndrome. […] It’s not usually a condition that’s passed along in families. But in some rare cases, people have it because a problem in their genes makes them more likely to get tumors on their glands. […] Cushing’s disease is a type of Cushing’s syndrome. It happens when there’s a tumor in the pituitary gland, which makes your body produce too much cortisol.

• #8 Cushing Syndrome: Causes and Symptoms

  https://www.massgeneral.org/children/cushing-syndrome

  Cushing syndrome can be caused by endogenous (internal) and/or exogenous (external) factors. […] Tumor of the adrenal gland. […] Too much adrenocorticotropic hormone (ACTH), a hormone made by the pituitary gland, that stimulates the adrenal glands to make cortisol. […] Other tumors that make too much ACTH. […] High levels of other hormones that increase ACTH production (such as CRH). […] Long-term use of moderate to high doses of medications called glucocorticoids. Glucocorticoids include hydrocortisone, prednisone, prednisolone, dexamethasone and other similar medications. These medications are used to reduce inflammation in conditions such as asthma, arthritis, inflammatory bowel disorders and connective tissue disorders. While taking these medications by mouth is the most common cause of Cushing syndrome, this condition also occurs with prolonged and heavy exposure to glucocorticoids applied on the skin or inhaled. Thus, it is very important to follow the directions of a health care professional to avoid overuse of such medications.

• #9 Cushing’s syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Cushing%27s_syndrome

  Several possible causes of Cushing’s syndrome are known including the taking of herbal supplements over-the-counter that do not list glucocorticoids in their ingredients. […] The most common cause of Cushing’s syndrome is the use of prescribed glucocorticoids to treat other diseases (iatrogenic Cushing’s syndrome). […] In pituitary Cushing’s, a benign pituitary adenoma secretes ACTH. This is also known as Cushing’s disease and is responsible for 70% of endogenous Cushing’s syndrome. […] In adrenal Cushing’s, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia. […] Tumors outside the normal pituitary-adrenal system can produce ACTH (occasionally with CRH) that affects the adrenal glands. This etiology is called ectopic or paraneoplastic Cushing’s disease and is seen in diseases such as small cell lung cancer.

• #10 Cushing’s syndrome: when cortisol floods the blood – USZ

  https://www.usz.ch/en/disease/cushings-syndrome/

  The rare endogenous Cushings syndrome occurs when the body produces too much cortisol without external influences. […] If endogenous Cushings syndrome develops in an ACTH-dependent manner, this means that your organism produces too much of the control hormone ACTH, which subsequently causes the adrenal glands to produce too many glucocorticoids. […] If an endogenous Cushings syndrome develops independently of the control hormone ACTH, then the reasons for this lie in the adrenal gland itself (i.e. adrenal). […] In most cases, Cushings syndrome appears in the exogenous form, i.e. as a result of long-term drug treatment with glucocorticoids. […] Endogenous Cushings syndrome (hypercortisolism) is a rare disease with a frequency of around 2-5 cases per 1 million inhabitants per year. […] The prognosis for exogenous Cushings syndrome is good. […] The prognosis for endogenous Cushings syndrome depends on how well the triggering disease, usually a tumor, can be treated. […] The course of Cushings syndrome depends on the cause.

• #11 Cushing’s Syndrome: Causes and Treatment | Doctor

  https://patient.info/doctor/cushings-syndrome-pro

  Cushing’s syndrome is caused by prolonged exposure to elevated levels of either endogenous or exogenous glucocorticoids. The degree of cortisol overproduction is very variable. When presentation is florid, diagnosis is usually straightforward. […] Causes of Cushing’s syndrome can be divided into two groups: Adrenocorticotropic hormone (ACTH)-dependent disease: excessive ACTH from the pituitary gland (Cushing’s disease), ectopic ACTH-producing tumours or excess ACTH administration. […] The most common cause of Cushing’s syndrome is the use of exogenous glucocorticoids. Endogenous Cushing’s syndrome is divided into corticotropin-dependent and corticotropin-independent causes: Corticotropin-dependent causes account for about 80-85% of cases: 80% are due to pituitary adenomas (Cushing’s disease). […] Corticotropin-independent Cushing’s syndrome: Is most often due to a unilateral tumour: adrenal adenoma in 60% and adrenal carcinoma in 40% of cases.

• #12 Cushing Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470218/

  Cushing syndrome is caused by prolonged exposure to high circulating levels of cortisol. The most common cause of cushingoid features is iatrogenic corticosteroid use, while some herbal preparations can also increase circulating corticosteroid levels leading to Cushing syndrome. Cushing syndrome can be interchangeably called hypercortisolism. ACTH-dependent cortisol excess due to a pituitary adenoma is called Cushing disease, and it is responsible for 80% of endogenous Cushing syndrome. […] There are two main etiologies of Cushing syndrome: endogenous hypercortisolism and exogenous hypercortisolism. Exogenous hypercortisolism, the most common cause of Cushing syndrome, is mostly iatrogenic and results from the prolonged use of glucocorticoids. Endogenous Cushing syndrome results from excessive production of cortisol by adrenal glands and can be ACTH-dependent and ACTH-independent. ACTH-secreting pituitary adenomas (Cushing disease) and ectopic ACTH secretion by neoplasms are responsible for ACTH-dependent Cushing. Adrenal hyperplasia, adenoma, and carcinoma are major causes of ACTH-independent Cushing syndrome.

• #13 Cushing Disease / Cushing Syndrome | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/cushing-disease-cushing-syndrome

  Cushing disease occurs when a pituitary adenoma, a noncancerous (benign) tumor on the pea-size pituitary gland, makes too much adrenocorticotropic hormone (ACTH). […] In response, the body’s two adrenal glands, one atop each kidney, make too much cortisol. This causes problems with your body’s hormone balance. […] Only about 10% of pituitary adenomas make too much ACTH. The tumor can also be small (microadenoma) or large (macroadenoma). […] In Cushing syndrome (also called Cushing’s syndrome), excess cortisol can come from outside or inside the body. For example, it can come from using corticosteroid medications, such as prednisone. Or it can come from a pituitary or adrenal tumor causing the body to make too much cortisol. […] Cushing disease is a specific type of Cushing syndrome. It occurs when a pituitary tumor causes the body to make too much cortisol. Cushing disease is the most common form of endogenous (from the body) Cushing syndrome, and makes up about 70% of Cushing syndrome cases.

• #14 Cushing’s syndrome: Causes, symptoms, types, and diagnosis

  https://www.medicalnewstoday.com/articles/172744

  Cushings syndrome is a hormonal condition that occurs when a persons cortisol levels are too high. […] It often results from using medications that lead to high levels of cortisol in the body, but other causes include a benign or cancerous tumor. […] One cause of Cushings syndrome is Cushings disease. This is a rare condition that happens when a pituitary adenoma a non-cancerous tumor in the pituitary gland releases high levels of a hormone known as adrenocorticotropic hormone (ACTH). […] These high levels of ACTH trigger high levels of cortisol, resulting in a range of symptoms. […] Apart from those with Cushings disease, people who are at risk of developing Cushings syndrome include those who: take large doses of steroid medication for another illness, such as asthma; have a tumor in the adrenal gland; have cancerous tumors that produce ACTH, for example, certain lung cancers.

• #15 Cushing disease: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000348.htm

  Cushing disease is a cause of Cushing syndrome. Other causes of Cushing syndrome include exogenous Cushing syndrome, Cushing syndrome caused by an adrenal tumor, and ectopic Cushing syndrome. […] Cushing disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. A type of pituitary tumor called an adenoma is the most common cause. An adenoma is a benign tumor (not a cancer). […] With Cushing disease, the pituitary gland releases too much ACTH. ACTH stimulates production and release of cortisol, a stress hormone. Too much ACTH causes the adrenal glands to make too much cortisol.

• #16 Cushing’s Disease | Pacific Pituitary Disorders Center

  https://www.pacificneuroscienceinstitute.org/pituitary-disorders/conditions/pituitary-adenomas/cushings-disease/

  Cushings disease is caused by an ACTH-secreting pituitary adenoma, the vast majority of which are benign tumors (not cancerous). This serious endocrinopathy is a subset of Cushings syndrome which refers to elevated blood cortisol levels. Cushings syndrome results from tumors of the pituitary, adrenal glands or from tumors elsewhere in the body (ectopic ACTH producing tumors). The cause of Cushings syndrome is a pituitary adenoma in over 70% of patients. […] Most ACTH adenomas are microadenomas. Cushings disease is relatively uncommon, affecting 10-15 of every million people each year, and most commonly in adults aged 20-50 years old; women account for over 70% of cases. […] The first step in diagnosing Cushings disease is to confirm excessive cortisol secretion which is done by performing a 24-hour urinary free cortisol collection, midnight salivary cortisol test and/or a low-dose dexamethasone suppression test. If blood ACTH levels are elevated or normal, then the source is from either an ACTH-secreting pituitary adenoma or an ectopic (elsewhere in the body) ACTH-producing tumor. A high-dose dexamethasone suppression test and/or petrosal sinus sampling are tests used to distinguish between ectopic ACTH production and pituitary ACTH production (Cushings disease).

• #17 SciELO Brazil – Unusual causes of Cushing’s syndrome Unusual causes of Cushing’s syndrome

  https://www.scielo.br/j/abem/a/hkTDwN4Xr4SsvpDJ7mjg59d/?lang=en

  The ACTH-dependent variety of the syndrome is either due to ACTH hypersecretion from pituitary corticotroph adenomas (Cushing’s disease) and represents the vast majority of cases (70%) or to ectopic ACTH secretion from various tumour types. […] The ACTH-independent forms of Cushing’s syndrome include adrenal adenomas, carcinomas, and two rare forms of bilateral adrenal pathology, namely ACTH-independent macronodular adrenal hyperplasia (AIMAH) and primary pigmented (micro)nodular adrenal disease (PPNAD). […] Ectopic corticotroph adenomas represent a rare finding and most of them are located in the sphenoid sinus and the suprasellar region but also in the cavernous sinus and the parasellar region. […] Ectopic CRH syndrome as a cause of false-positive result during BIPSS has been underlined by Young et al.

• #17 SciELO Brazil – Unusual causes of Cushing’s syndrome Unusual causes of Cushing’s syndrome

  https://www.scielo.br/j/abem/a/hkTDwN4Xr4SsvpDJ7mjg59d/?lang=en

  Although the definite differential diagnosis of bilateral adrenocortical adenomas from PPNAD and AIMAH is by histological examination, identifying them preoperatively is of great importance because it will affect the surgical approach. […] The terms „cortisol hyperreactive syndrome”, „glucocorticoid hypersensitivity syndrome”, and „normocortisolemic Cushing’s syndrome” have been used to describe the development of a typical Cushing’s phenotype despite normal or even low serum cortisol levels. […] Megestrol acetate, a progestational pharmaceutical compound used in the treatment of advanced breast and endometrial cancer and for the cachexia and wasting associated with HIV infection has also been shown to cause Cushing’s syndrome. […] Exogenous Cushing syndrome in HIV-infected patients receiving ritonavir and fluticasone, even in daily doses of less than 1000 mg, has been reported frequently.

• #18 Cushing Syndrome: Signs, Causes, and Treatment

  https://www.healthline.com/health/cushings-syndrome

  Cushing syndrome can happen for a variety of reasons. […] Cushing syndrome can occur when you have high levels of the hormone cortisol in your body for a long period. Cortisol is produced by your adrenal glands. […] However, experts note that Cushing syndrome is caused by long term stress related to corticosteroid use or tumors in the body. […] The most common cause of Cushing syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. […] Several kinds of tumors can also lead to a higher production of cortisol. […] When you have pituitary gland tumors, the pituitary gland releases too much adrenocorticotropic hormone (ACTH), which stimulates cortisol production in the adrenal glands. This is called Cushing disease. […] Ectopic tumors usually occur in the lung, pancreas, thyroid, or thymus gland. […] An adrenal abnormality or tumor can lead to irregular patterns of cortisol production, which can cause Cushing syndrome. […] Although Cushing syndrome isn’t typically inherited, it’s possible to have an inherited tendency to develop tumors of the endocrine glands.

• #19 SciELO Brazil – Unusual causes of Cushing’s syndrome Unusual causes of Cushing’s syndrome

  https://www.scielo.br/j/abem/a/hkTDwN4Xr4SsvpDJ7mjg59d/?lang=en

  Although in the majority of the patients with Cushing’s syndrome (CS), hypercortisolism is due to ACTH hypersecretion by a pituitary tumour or to ectopic ACTH secretion from an extrapituitary neoplastic lesion or to autonomous cortisol secretion by an adrenal tumour, in occasional patients a much rarer entity may be the cause of the syndrome. […] The following unusual forms of CS were identified: (i) ACTH hyperesecretion due to ectopic corticotroph adenomas in the parasellar region or the neurohypophysis, or as part of double adenomas, or gangliocytomas; (ii) ACTH hypersecretion due to ectopic CRH or CRH-like peptide secretion by various neoplasms; (iii) ACTH-independent cortisol hypersecretion from ectopic or bilateral adrenal adenomas; (iv) glucocorticoid hypersensitivity; (v) iatrogenic, due to megestrol administration or to ritonavir and fluticasone co-administration.

• #20 Cushing Syndrome – Endocrine and Metabolic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/adrenal-disorders/cushing-syndrome

  Rare causes of ACTH-independent hyperfunction include primary pigmented nodular adrenal dysplasia (usually in adolescents) and bilateral macronodular hyperplasia (in older adults). […] Whereas the term Cushing syndrome denotes the clinical picture resulting from corticosteroid excess from any cause, Cushing disease refers to hyperfunction of the adrenal cortex due to pituitary ACTH excess. Patients with Cushing disease almost always have a small adenoma of the pituitary gland.

• #21 Cushing syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310

  Cushing syndrome happens when the body has too much of the hormone cortisol for a long time. This can result from the body making too much cortisol, or from taking medicines called glucocorticoids, which affect the body the same way as cortisol. […] Cushing syndrome is caused by having too much cortisol in the body. Cortisol is a hormone that is made in the adrenal glands. […] Cushing syndrome can happen from taking glucocorticoid medicines. These are often used to treat inflammatory diseases such as rheumatoid arthritis, lupus and asthma. […] A hormone made in the pituitary gland controls how much cortisol the body makes. This is called adrenocorticotropic hormone (ACTH). Some tumors make ACTH, which creates more cortisol and can cause Cushing syndrome. […] When Cushing syndrome happens this way, it may be caused by: ACTH-producing pituitary adenoma. […] Ectopic ACTH-producing tumor. […] Adrenal gland tumors or disease. […] Familial Cushing syndrome. Rarely, people inherit a tendency to get tumors on one or more of their endocrine glands, which are glands that make hormones. If these tumors make ACTH or cortisol, Cushing syndrome can happen.

• #22 Cushing’s Syndrome/Disease – AANS

  https://www.aans.org/patients/conditions-treatments/cushings-syndrome-disease/

  Cushings syndrome is a disorder caused by the bodys exposure to an excess of the hormone cortisol. […] Cushings syndrome can be caused by overuse of cortisol medication, as seen in the treatment of chronic asthma or rheumatoid arthritis (iatrogenic Cushings syndrome), excess production of cortisol from a tumor in the adrenal gland or elsewhere in the body (ectopic Cushings syndrome) or a tumor of the pituitary gland secreting adrenocorticotropic hormone (ACTH) which stimulates the over-production of cortisol from the adrenal gland (Cushings disease). […] Pituitary adenomas are benign tumors of the pituitary gland that secrete increased amounts of ACTH causing excessive cortisol production. […] Some benign or malignant (cancerous) tumors that arise outside the pituitary gland can produce ACTH. This condition is known as ectopic ACTH syndrome. […] An abnormality of the adrenal glands, such as an adrenal tumor, may cause Cushings syndrome. […] Most cases of Cushings syndrome are not genetic. However, some individuals may develop Cushings syndrome due to an inherited tendency to develop tumors of one or more endocrine glands.

• #23 CUSHING SYNDROME: CAUSES, SYMPTOMS, AND TREATMENT | Mya Care

  https://myacare.com/blog/cushing-syndrome-causes-symptoms-and-treatment

  Cushing’s disease and Ectopic ACTH syndrome are ACTH dependent, meaning that diagnostic tests will show higher than average ACTH levels. ACTH-independent Cushing’s syndrome is not detectable by looking at ACTH levels. Common causes include adrenal gland enlargement (hyperplasia), adenoma, and carcinoma. […] There are various types of hereditary Cushing’s syndrome pertaining to specific hereditary tumors. These include Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder caused by an inactivating mutation in the MEN1 gene. […] Multiple endocrine neoplasia type 4 (MEN4) is a rare condition caused by a CDKN1B gene mutation. It is similar to MEN1 but can also cause tumors in the adrenal glands. […] Other mutations that increase the risk of developing Cushing’s syndrome include PDE11A and PDE8B, yet their role is still under investigation. […] There are many more gene mutations associated with the development of pituitary gland tumors and other tumors that can cause Cushing’s syndrome.

• #24 Cushing’s disease | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/cushings-disease/

  Cushings disease is caused by a tumour in the pituitary gland. This tumour produces high levels of a hormone called adrenocorticotropic hormone which, in turn, causes the adrenal glands to produce excessive amounts of the hormone, cortisol. […] In most cases, the cause of the tumour cannot be identified. In a small number of cases, the pituitary tumour that causes Cushings disease is part of an inherited condition known as multiple endocrine neoplasia type 1.

• #25 Pseudo-Cushing Syndrome: Overview, Causes and Complications, History and Physical Examination

  https://emedicine.medscape.com/article/124718-overview

  Pseudo-Cushing syndrome (PCS), or as it has been more recently renamed „non-neoplastic hypercortisolism,” is a group of conditions associated with clinical and biochemical features of Cushing syndrome, but the hypercortisolemia is usually secondary to other factors. […] A particular type of hypercortisolism presenting during the above conditions, named functional hypercortisolism, is caused by chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis. […] The mechanism behind PCS is unclear. Most evidence suggests central stimulation of a corticotropin-releasing hormone (CRH), either at the hypothalamic or suprahypothalamic level. […] A two-hit hypothesis has been considered for alcohol induced PCS. In alcoholic chronic liver disease, there is an increased cortisol secretion rate with impaired cortisol metabolism, instead of impaired cortisol secretion, and that is actually leading to increased cortisol levels.

• #25 Pseudo-Cushing Syndrome: Overview, Causes and Complications, History and Physical Examination

  https://emedicine.medscape.com/article/124718-overview

  Some studies suggest that there is a direct stimulatory effect of alcohol in the cortisol secretion. […] Similar mechanism of HPA axis hyperactivity is presumed for depressed patients. […] Anorexia nervosa is associated with CRH-driven hyperactivity of the HPA axis due to starvation and therefore represents a model of functional hypercortisolism that shares similar pathophysiologic mechanisms as seen in other causes of PCS. […] In obesity, postulated mechanisms of hyperactivation of HPA axis include hyper-responsiveness to different neuropeptides, stress events, dietary factors, as well as a stimulation caused by augmented peripheral metabolism and clearance of cortisol by reduced conversion of cortisone to cortisol by 11-HSD1 and increased conversion of cortisol to 5-reduced derivatives. […] In PCOS, activation of the HPA axis is secondary to increased cortisol metabolism due to augmented 5- and 5-reductase and decreased 11-HSD1 activity.

• #26 Cushing’s Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/hormones/cushings-syndrome-leaflet

  There are various rare disorders of the adrenal glands which can cause high levels of cortisol. […] Some rare tumours in other parts of the body sometimes make ACTH – for example, some types of lung cancer. The ectopic ACTH (ie ACTH not made in the pituitary gland) then stimulates the adrenal glands to make too much cortisol. […] Some people take steroid medicines which are similar to cortisol – for example, prednisolone. This is sometimes used to treat various conditions such as some types of arthritis and some cancers. The side-effects of long-term treatment with steroids can cause symptoms and problems similar to Cushing’s syndrome. […] Some people who drink a lot of alcohol make too much cortisol. The cortisol level goes back to normal if drinking alcohol stops. […] Some people with severe depression make too much cortisol.

• #27 Cushing’s disease: causes, treatment, and more | St. Luke’s Health

  https://www.stlukeshealth.org/services-specialties/endocrinology/cushings-disease

  Cushing’s disease is primarily caused by an overproduction of the hormone cortisol in the body. This overproduction typically results from a noncancerous tumor located in the pituitary gland, which is a small gland at the base of the brain. The tumor is usually a benign adenoma, meaning it is not cancerous. […] The most common cause of Cushing’s disease is a pituitary tumor, specifically an adenoma. These tumors are often small and noncancerous but can produce excessive amounts of adrenocorticotropic hormone (ACTH). […] The pituitary tumor prompts the overproduction of ACTH. ACTH is responsible for stimulating the adrenal glands, which are situated on top of the kidneys, to produce cortisol. […] The elevated levels of ACTH in the bloodstream result in the adrenal glands producing more cortisol than the body needs. This excess cortisol leads to the various symptoms and health problems associated with Cushing’s disease.

• #28

  https://step2.medbullets.com/endocrine/120109/cushing-syndrome–disease

  etiologies […] pituitary overproduction: […] ACTH-secreting tumor (usually an adenoma) […] ectopic production: […] ACTH-secreting malignancy of a neuroendocrine origin such as small-cell lung cancer […] ACTH-independent (ACTH is normal or low) […] cortisol overproduction — negative feedback — lowers ACTH — atrophy of normal adrenal tissue […] etiologies […] exogenous intake (usually patients prescribed systemic glucocorticoids for inflammatory conditions) […] most common cause of Cushing’s syndrome […] may cause bilateral adrenal atrophy […] adrenal overproduction (by adrenal adenoma, carcinoma or nodular hyperplasia) […] may cause atrophy of the contralateral adrenal gland

• #29 Cushing’s Disease | UVA Health

  https://uvahealth.com/services/benign-brain-tumor/cushings-disease

  Cushing’s disease happens when you have too much adrenocorticotrophin hormone (ACTH). Too much ACTH causes your adrenal glands to make too much cortisol. […] Sometimes, Cushing’s disease is caused by a kind of tumor of your pituitary gland. Called an ACTH-producing pituitary tumor, it’s not cancer. But by putting your hormones out of balance, it does affect your whole body. […] In other cases, Cushing’s disease is caused by your medications. Changing your medications can improve your symptoms.

• #30 Cushing’s disease | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-7-41

  Cushing’s disease, or pituitary ACTH dependent Cushing’s syndrome, is a rare disease responsible for increased morbidity and mortality. […] Chronic glucocorticoid excess, or Cushing’s syndrome, may be due to ACTH-dependent (80% cases) or –independent (20% cases) causes. […] ACTH overproduction may be of pituitary origin (85% cases) or result from ectopic tumor secretion (15% cases). […] Cushing’s disease is defined by Adrenocorticotropin hormone (ACTH) hypersecretion, induced by a corticotroph adenoma, and leading to cortisol hypersecretion (associated with androgens hypersecretion). […] Cushing’s disease is frequently due to monoclonal benign and slow growing microadenomas (less than 10 mm). […] Altered CRH secretion as well as POMC qualitative changes in gene expression were also reported to be involved in the pathogenesis of Cushing’s disease.

• #31 Cushing’s Syndrome | The Surgery Group

  https://thesurgerygroup.com/condition/cushings-syndrome/

  Cushing’s syndrome, also known as hypercortisolism, occurs when there is too much cortisol in the body. This hormone, which regulates how the body uses energy, can cause damage when it is present in higher than normal levels. […] The most common cause of Cushing’s syndrome is an overuse of corticosteroid medications. These medications are prescribed for their anti-inflammatory properties and to aid healing. […] Cushing’s syndrome can also occur when the adrenal glands are producing too much cortisol. Triggers can include malnutrition, high levels of stress, athletic training, alcoholism, and depression. In some cases, Cushing’s may be caused by an adrenal gland tumor or overgrowth. It can also be caused by a tumor on the pituitary gland. […] Cushing’s syndrome is not hereditary. However, people can inherit a tendency to develop tumors on their endocrine glands.

• #32 Cyclic Cushing’s syndrome – CSRF – Cushing’s Support & Research Foundation

  https://csrf.net/doctors-articles/cyclical-and-subclinical-cushings/cyclic-cushings-syndrome/

  Cyclic Cushings syndrome appears to be more common than originally thought and may occur in patients with a variety of underlying tumors, including pituitary adenomas secreting adrenocorticotropin (ACTH), tumors outside the pituitary secreting ACTH (ectopic ACTH syndrome), and several types of adrenal tumors. […] It is not known why cyclic Cushings syndrome develops in some patients. Speculation and limited evidence suggests that episodic tumor hemorrhage or cell death and fluctuations in the regulation of hormone secretion may be underlying the presence of intermittent cortisol excess. […] Once the presence of Cushings syndrome has been documented, a search for the underlying tumor is in order. Measuring ACTH levels in the morning during a period of cortisol excess will generally distinguish between patients with ACTH-dependent Cushings (reflecting either pituitary or ectopic ACTH secretion) and ACTH-independent Cushings (caused by an adrenal tumor or hyperplasia).

• #33 Cushing’s Disease in Dogs | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/cushings-disease-in-dogs

  Cushing’s disease (also known as Cushings syndrome) is a condition in which the adrenal glands overproduce certain hormones. The most common cause of Cushing’s disease (85%-90% of all cases) is a tumor of the pituitary gland, which is located at the base of the brain. The tumor causes the pituitary gland to overproduce a hormone (ACTH) that stimulates the adrenal glands to produce cortisol. […] Cushing’s disease may be the result of a benign or malignant tumor (adenoma or carcinoma, respectively) of the adrenal gland. […] The third type of the disease is iatrogenic Cushing’s disease. It occurs when there is excessive use of an oral or injectable steroid.

• #34 Cushing’s Disease in Dogs: Symptoms, Diagnosis, and Management | PetMD

  https://www.petmd.com/dog/conditions/endocrine/cushings-disease-in-dogs-symptoms-diagnosis

  Cushings disease, also referred to as hyperadrenocorticism, is an endocrine disorder that is common among middle-aged and senior dogs. […] The most common cause of Cushings disease in dogs is a pituitary gland adenoma. This is a benign tumor that grows slowly and secretes ACTH, which stimulates the adrenal glands to produce cortisol. […] Less commonly, an adrenal gland masseither a (benign) adenoma or a (cancerous) carcinomadevelops and secretes excess cortisol. […] Dogs who receive corticosteroids, such as prednisone, to treat another medical condition, such as an autoimmune disease or allergies, may develop iatrogenic Cushings disease. […] Iatrogenic Cushings means that the medication is actually causing the symptoms of Cushings disease rather than a pituitary or adrenal gland tumor causing the disease. […] Certain breeds, including Poodles, Yorkshire Terriers, and Dachshunds, may be predisposed to Cushings disease due to genetics.

• #35 Treating Cushing’s Disease in Dogs | FDA

  https://www.fda.gov/consumers/consumer-updates/treating-cushings-disease-dogs

  Cushing’s disease results when the body produces too much of a hormone called cortisol. […] About 80% to 85% of Cushing’s is pituitary-dependent, meaning it’s triggered by a tumor on the pituitary, a pea-sized gland at the base of the brain. […] In the other 15% to 20% of Cushing’s dogs, a tumor in one or both adrenal glands produce excess cortisol. […] The type of Cushing’s disease may determine what kind of treatment is prescribed. […] Most veterinarians treat both adrenal- and pituitary-dependent Cushing’s disease with medication. […] The only way to „cure” Cushing’s disease is to remove the adrenal tumor if the disease is adrenal-dependent and the tumor hasn’t spread. […] Vetoryl (trilostane) is the only drug approved by FDA to treat both pituitary- and adrenal-dependent Cushing’s in dogs.

• #36 Cushing’s Syndrome | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/cushings-syndrome

  Cushing’s syndrome is a rare hormonal disorder that occurs when the body’s tissues are exposed to excessive levels of the hormone cortisol for a long period of time. […] Benign, or non-cancerous, tumors of the pituitary gland called pituitary adenomas that secrete excessive amounts of adrenocorticotrophic hormone (ACTH) cause an estimated 70 percent of Cushing’s syndrome cases in adults and is referred to as Cushing’s disease. Other causes include tumors of the adrenal glands, which are located above the kidneys, as well as tumors occurring elsewhere in the body, such as the lungs, that secrete ACTH. This condition is known as ectopic ACTH syndrome. […] Rarely, some people may have an inherited tendency to develop tumors of one or more endocrine glands that can lead to Cushing’s syndrome.

• #37 Cushing syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/diagnosis-treatment/drc-20351314

  Taking glucocorticoid medicines is the most common way to get Cushing syndrome. […] When Cushing syndrome is caused by the body making too much cortisol, it can be hard to diagnose. […] If Cushing syndrome is caused by taking glucocorticoid medicine for a long time, your health care provider may be able to control your symptoms by lowering how much medicine you take. […] If Cushing syndrome is caused by a tumor, your health care provider may recommend removing the tumor with surgery. […] If an ACTH-producing tumor isn’t found, or if one can’t be fully removed and Cushing syndrome continues, your health care provider may recommend removing the adrenal glands. […] Medicines can be used to control cortisol levels when surgery and radiation don’t work or aren’t an option. […] Mifepristone does not lower the amount of cortisol the body makes, but it blocks the effect of cortisol on tissues. […] Pasireotide is given as a shot two times a day. It works by lowering the amount of ACTH from the tumor, which lowers cortisol levels.

• #38 Cushing Syndrome – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/adrenal-gland-disorders/cushing-syndrome

  Sometimes a noncancerous tumor (adenoma) develops in the adrenal glands, which causes them to overproduce corticosteroids. […] Cushing syndrome can also develop in people who must take large doses of corticosteroids (such as prednisone or dexamethasone) because of a serious medical condition. […] Cushing disease is a term given specifically to Cushing syndrome caused by overstimulation of the adrenal glands, usually because of a pituitary tumor. […] Cushing disease is treated with surgery or radiation to remove the pituitary tumor. […] If the problem is caused by taking corticosteroids, doctors weigh the benefit of the medication against the harm of having Cushing syndrome. […] Tumors of the adrenal glands (usually benign adenomas) can often be removed surgically. […] Tumors outside the pituitary and adrenal glands that secrete excess hormones are usually surgically removed.

Zobacz więcej