The nurse should monitor the client with Cushings disease for which finding
Left untreated, Cushing syndrome can result in exaggerated facial roundness, weight gain around the midsection and upper back, thinning of the arms and legs, easy bruising, and stretch marks. Show
Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid medication. Or your body might produce too much cortisol. Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes. Treatments for Cushing syndrome can return your body's cortisol levels to normal and improve your symptoms. The earlier treatment begins, the better your chances for recovery. Products & Services
SymptomsThe signs and symptoms of Cushing syndrome can vary depending on the levels of excess cortisol. Common signs and symptoms of Cushing syndrome
Signs and symptoms women with Cushing syndrome may experience
Signs and symptoms men with Cushing syndrome may experience
Other possible signs and symptoms of Cushing syndrome
When to see a doctorContact your doctor if you have symptoms that suggest Cushing syndrome, especially if you're taking corticosteroid medication to treat a condition such as asthma, arthritis or inflammatory bowel disease. Request an Appointment at Mayo Clinic There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. From Mayo Clinic to your inboxSign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. ErrorEmail field is required ErrorInclude a valid email address Learn more about Mayo Clinic’s use of data.To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Taking glucocorticoid medications is the most common cause of Cushing syndrome. Your doctor can review all your medications — pills, injections, creams and inhalers — to determine if you're taking medications that can cause the disorder. If you are, you probably won't need other tests. Cushing syndrome from endogenous cortisol production can be difficult to diagnose because other conditions have similar signs and symptoms. Diagnosing Cushing syndrome can be a long and extensive process. You'll likely need to see a doctor who specializes in hormonal disorders (endocrinologist). Your doctor will conduct a physical exam and look for indications of Cushing syndrome, such as rounding of the face, a pad of fatty tissue between the shoulders and neck, and thin skin with bruises and stretch marks. If you haven't been using a corticosteroid medication, these diagnostic tests may help pinpoint the cause:
These tests help your doctor diagnose Cushing syndrome, and they may help rule out other medical conditions, such as polycystic ovary syndrome — a hormone disorder in women with enlarged ovaries. Depression, eating disorders and alcoholism also can partially mimic Cushing syndrome. Care at Mayo ClinicOur caring team of Mayo Clinic experts can help you with your Cushing syndrome-related health concerns Start Here More Information
TreatmentTreatments for Cushing syndrome are designed to lower the high level of cortisol in your body. The best treatment for you depends on the cause of the syndrome. Options include: Reducing corticosteroid useIf the cause of Cushing syndrome is long-term use of corticosteroid medications, your doctor may be able to keep your Cushing syndrome signs and symptoms under control by reducing the dosage of the drug over a period of time, while still managing the condition for which you take it. Don't reduce the dose of corticosteroid drugs or stop taking them on your own. Do so only under your doctor's supervision. Abruptly discontinuing these medications could lead to deficient cortisol levels. Slowly tapering off corticosteroid drugs allows your body to resume normal cortisol production. SurgeryIf the cause of Cushing syndrome is a tumor, your doctor may recommend complete surgical removal. Pituitary tumors are typically removed by a neurosurgeon, who may perform the procedure through your nose. For a tumor in the adrenal glands, lungs or pancreas, the surgeon can remove it through a standard operation or by using minimally invasive surgical techniques, with smaller incisions. After the operation, you'll need to take cortisol replacement medications to provide your body with the correct amount of cortisol. In most cases, you'll eventually return to normal adrenal hormone production, and your doctor can taper off the replacement drugs. Your endocrinologist will use blood tests to help determine if you need cortisol replacement and when it may be stopped. However, this process can take up to a year or longer. In some instances, people with Cushing syndrome never return to normal adrenal function. They then need lifelong replacement therapy. Radiation therapyIf the surgeon can't totally remove a pituitary tumor, he or she will usually prescribe radiation therapy as well as surgery. Additionally, radiation may be used for people who aren't suitable candidates for surgery. Radiation can be given in small doses over a six-week period, or with a technique called stereotactic radiosurgery. In the latter procedure, a large, one-time dose of radiation is delivered to the tumor, and the radiation exposure to surrounding tissues is minimized. MedicationsMedications can be used to control cortisol production when surgery and radiation don't work. Medications might also be used before surgery in people who have become very sick with Cushing syndrome to improve signs and symptoms and minimize surgical risk. Medical therapy may not completely improve all of the symptoms of excess cortisol. Medications to control excessive production of cortisol at the adrenal gland include ketoconazole, mitotane (Lysodren) and metyrapone (Metopirone). Mifepristone (Korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance. Mifepristone does not decrease cortisol production, but it blocks the effect of cortisol on your tissues. Side effects from these medications may include fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium and swelling. Some have more-serious side effects, such as neurological side effects and liver toxicity. Newer medications for Cushing syndrome include pasireotide (Signifor), given as a twice-daily injection, and osilodrostat (Isturisa), a pill. Other medications are being developed. In some cases, the tumor or its treatment will cause the pituitary or adrenal gland to produce not enough of other hormones, and your doctor will recommend hormone replacement medications. If none of these treatment options is appropriate or effective, your doctor may recommend surgical removal of your adrenal glands (bilateral adrenalectomy). This procedure will cure excess production of cortisol but will require lifelong replacement medications. More Information
Request an Appointment at Mayo Clinic There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Email ErrorEmail field is required ErrorInclude a valid email address To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. |