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Cushing's syndrome (cortisol-producing adrenal tumor)

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What is Cushing's syndrome?

Cushing's Syndrome: Harvey Cushing
Figure 4: Harvey Cushing

Cushing's syndromeCushing's syndrome - a disease where too much cortisol is being made is named after Harvey Cushing, a famous neurosurgeon at Johns Hopkins Hospital who first described it. Patients who have Cushing's syndrome have too much cortisolCortisol - a glucocorticoid that controls glucose production and suppresses the immune system or steroid in their blood. Cortisol is a hormoneHormone - a chemical made by a gland that travels in the bloodstream and "tells organs what to do." made by the adrenal glands that plays an essential role in the stress response. Normal cortisol levels are necessary to sustain life, to maintain normal sleep-wake cycles, and to enable the body to respond to stressful events. Though limited bursts of cortisol are normal, long-term elevations of the cortisol level are harmful to many organ systems. Cushing's syndrome can be caused by either taking too much steroids as a medication or if the body makes too much steroid.

People who take prescription medications similar to cortisol in high doses for a long period of time for inflammatory diseases (such as rheumatoid arthritis, asthma, and inflammatory bowel disease) may develop Cushing's syndrome. In fact, this is the most common cause of Cushing's syndrome and is termed "iatrogenic", i.e. caused by the doctor. Medications that are similar to cortisol are called glucocorticoids, corticosteroids, or sometimes just "steroids" for short. They are not the same as the performance-enhancing steroids taken by some athletes. The most commonly prescribed glucocorticoid medication is called prednisone. Because glucocorticoids suppress the immune system, they reduce inflammation and are also frequently given to people who have had organ transplants to prevent the immune cells from attacking the transplant.

If the patient's body is making too much cortisol (i.e. endogenous Cushing's syndrome), there are 3 possible sources:

The causes of Cushing's syndrome can be divided into:

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