Cushing's syndrome

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What is it?

Cushing’s syndrome is a group of signs and symptoms caused by the body producing too much cortisol from the adrenal glands.There are two adrenal glands, one on top of each kidney.  These glands are triangular in shape.  Cushing’s syndrome can also be caused by a patient taking too much of a synthetic glucocorticoid (a steroid like cortisol) for another clinical condition.

Cushing’s syndrome can occur in anyone but more commonly it occurs in adults aged 20-50 years. It is more common in women.

There are several causes of Cushing’s syndrome:

  • Iatrogenic Cushing’s syndrome. Taking synthetic glucocorticoids. These drugs, such as prednisolone and dexamethasone, act like cortisol.
  • Cushing’s disease. A pituitary tumour that produces large amounts of adrenocorticotrophic hormone (ACTH).
  • Adrenal tumour. A tumour in the adrenal gland that produces too much cortisol.
  • Adrenal nodular hyperplasia. When groups of cells, or nodules, in the adrenal gland produce too much cortisol.
  • Ectopic ACTH. A tumour in the body, not associated with the pituitary gland, that produces too much ACTH. This ACTH stimulates the adrenal glands to produce too much cortisol.
  • Ectopic CRH. A tumour in the body, not associated with the hypothalamus, that produces too much corticotrophin releasing hormone (CRH). This stimulates the pituitary to secrete large amounts of ACTH that in turn stimulates the adrenal glands to produce too much cortisol.
  • Adrenal carcinoma. Very rarely cancer in the adrenal.
  • In some rare cases Cushing’s syndrome may develop because of gene mutations associated with other clinical conditions.
  • The first two causes of Cushing’s syndrome on this list are the most common ones.

    There is a large number of symptoms and signs that can be seen with Cushing’s syndrome (see symptoms).

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