Cushing's disease: symptoms, photo, treatment of the syndrome Cushing

Cushing's disease pituitary - neuroendocrine pathology often of unknown etiology. For the disease characterized by excessive production of corticosteroid hormones that regulate metabolic processes in the body.

The syndrome develops as a result of dysfunction of the hypothalamus, thalamus, reticular formation, which naturally causes changes in pituitary, it produces too much adrenocorticotropic hormone (ACTH), which triggers the production of corticosteroid in the cortex adrenal.

What it is?

Pituitary - Cushing - neuroendocrine disorder characterized by increased production of hormones crust adrenal glands, which is caused by excessive secretion of ACTH cells hyperplastic pituitary tissue or tumor (90% microadenoma).

Causes of

The causes of the disease is not fully defined. We can only say that according to statistics from the pituitary Cushing's syndrome patients suffer from a history which there are injuries, traumatic brain injury, concussion, encephalitis, an inflammation of the meninges and other injuries to the head, brain and spinal cord, CNS delivery in women.

1. Recent studies have found that the disease is often associated with a pituitary adenoma, other tumors (Adrenal gland, and sometimes the lungs, pancreas cancer, bronchial adenoma, cancer in the testes, ovaries).
2. Neuroendocrine provoke this pathology might high doses of steroid hormones in the treatment of arthritis or asthma. Therefore it is impossible for a long time use in high doses "Hydrocortisone", "Methylprednisolone" and similar gormonosoderzhaschie medication.
3. Not the last factor in the disease is the development of a genetic predisposition.

Occasionally the disease may provoke alcoholism, some liver pathology.

Symptoms of Cushing's disease

The person with the disease Cushing's gradually becomes quite specific appearance - lunate shaped red face, fat body with thin limbs (see. Photo).

On the abdomen due to obesity stretch marks appear. Designated friction (elbows and neck) and skin fold because of increased pigmentation become darker than other portions of the skin. The disease significantly reduces immunity, resulting in approximately 50% of patients die from infectious diseases. Against the background of Cushing's disease often develop serious psychological disorder.

Key features of Cushing's disease:

1. A person becomes a "lunoobraznym";
2. Increased blood pressure (hypertension);
3. Decreased bone density (osteoporosis);
4. Increased blood sugar (hyperglycemia);
5. There is an increased deposition of fat in the areas: the abdomen, shoulders, neck and face;
6. The resulting tissue is muscular dystrophy thinning extremities;
7. There is muscle weakness;
8. There is a clearly defined venous pattern on the limbs and the chest;
9. Women are possible manifestations of body hair of male type.

The disease can be progressive (symptoms developed over six to twelve months) and torpid (gradual increase in symptoms within three to ten years).

The forms of the clinical course

The severity of Cushing's disease can be mild, moderate or severe.

1. Mild disease is accompanied by moderately severe symptoms: menstrual function can be maintained, osteoporosis sometimes offline.
2. With an average severity of Cushing's disease symptoms expressed clearly, but complications do not develop.
3. A severe form of the disease characterized by the development of complications: muscle atrophy, hypokalemia, hypertension, kidney, severe mental disorders, etc...

The speed of development of pathological changes distinguish progressive and torpid for Cushing's disease. Progressive course characterized by rapid (within 6-12 months) increase of the symptoms and complications of the disease; with torpid course lesions formed gradually over 3-10 years.

Diagnostics

Diagnosis of Cushing's Syndrome Cushing - a difficult and responsible process, the accuracy and timeliness of which depends on the life, health. It includes:

• Urinalysis, blood to determine the level of cortisol and ACTH concentrations;
• CT and MRI of the peritoneum;
• ultrasound;
• X-rays of the spine;
• biochemical research, tests with dexamethasone CRH, ACTH to clarify the localization of pathology in the body.

On examination, and examination of the patient is very important to rule out other possible diseases before setting the final diagnosis.

Treatment of the disease Cushing

When the pituitary - Cushing treatment is aimed at eliminating the hypothalamic shifts the restoration of the metabolism, normalizing the secretion of corticosteroids and ACTH. To this end assigned medical therapy, surgical therapy, proton therapy hypothalamic-pituitary region, gamma, X-ray therapy, diet therapy, and a combination of various methods.

Depending on the shape of gravity Cushing's disease physicians prescribe:

• Medication when written out dopamine receptor agonists, anticancer drugs, and drugs that slow the synthesis of steroids.
• In severe cases, it justified the use of surgical treatment, when administered one or both sides adrenalectomy introduction in them, destroying their structure, removal of hypophysis neoplasms.
• Radiation therapy - proton, or gamma with moderate and severe.

For the normalization of the organs and systems provide symptomatic treatment. In this case:

• upon detection of heart failure - drugs digitalis and cardiac glycosides;
• in hypertension prescribe diuretics and drugs for reducing the pressure;
• osteoporosis - vitamin complexes with the vitamin D, preparations for the restoration of bone protein structure and improve calcium absorption processes;
• diabetes prescribe strict diet with binding taking drugs for lowering blood sugar;
• to strengthen the immune system's disease Cushing's doctor prescribes a means to stimulate the growth and maturation of lymphocytes.

With a view to the prevention of osteoporosis and kidney stones, doctors advise them to eat eggs, dairy products, and obesity - abandon salts and fatty foods, and to increase the amount of water drunk day.

Forecast

It depends on the duration, severity of disease symptoms and the patient's age:

• with short duration of the disease, its mild form and age of the patient under 30 years favorable prognosis;
• srednetyazholyh in cases with long-term course of the disease after the normalization of the function of the adrenal cortex often saved irreversible disorders of the cardiovascular system, kidney function, hypertension, diabetes, osteoporosis;
• bilateral adrenalectomy leads to the development of chronic adrenal insufficiency, which requires constant hormone replacement therapy to prevent the development of Nelson syndrome.

In the case of full recourse disabled symptoms can be saved. When total adrenalectomy lost the ability to work.

prevention

People with symptoms of Cushing's disease - Cushing need to be observed at the various specialists and to avoid excessive psycho-emotional and physical stress. Also obscheprofilakticheskie measures include combating neuroinfections, intoxication, prevention of head injuries, and so on. D.