Cushing's Syndrome

Cushing's syndrome develops when the body is exposed to high levels of cortisol for a prolonged time. The most common cause is long-term use of corticosteroid medications; less commonly, the body produces too much cortisol from a tumor.

Table of Contents

Quick Facts

  • ICD-10: E24
  • Common cause: Steroid medication use
  • Hallmark features: Weight gain, round face, easy bruising

Symptoms

  • Weight gain, especially around the trunk; arms and legs may be thinner
  • Round, full ('moon') face
  • Fat pad between the shoulders
  • Purple or pink stretch marks (striae)
  • Thin, fragile skin that bruises easily
  • Slow wound healing
  • Acne, oily skin
  • Increased body or facial hair (women)
  • High blood pressure
  • High blood sugar
  • Mood changes, depression
  • Muscle weakness
  • Osteoporosis
  • Menstrual irregularities

Causes

  • Long-term oral, inhaled, or injected corticosteroid medications (most common)
  • Pituitary tumor producing ACTH (Cushing's disease)
  • Adrenal tumor producing cortisol
  • Ectopic ACTH production from other tumors

Diagnosis

  • 24-hour urinary free cortisol
  • Late-night salivary cortisol
  • Dexamethasone suppression test
  • ACTH level to localize cause
  • Imaging (pituitary MRI, adrenal CT)

Treatment

  • Gradual reduction of steroid medication when possible
  • Surgery for pituitary, adrenal, or ectopic tumors
  • Radiation therapy in some cases
  • Medications to lower cortisol production
  • Adrenalectomy for selected cases

Related Conditions

Addison's Disease

Opposite — low cortisol

 Osteoporosis

Cushing's complication

 Diabetes

Often coexists

Frequently Asked Questions

Can inhaled steroids cause Cushing's?

High-dose inhaled steroids over long periods can occasionally cause systemic effects, but this is much less common than with oral steroids.

Will I need to take steroids forever after surgery?

After surgical removal of a cortisol-producing tumor, the body's own steroid production is temporarily suppressed. Replacement steroids are usually needed for months until normal function returns.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • Endocrine Society. Cushing's Syndrome Patient Resources.