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- Adrenal gland
- Anatomy of the adrenal gland
- Histology of adrenal gland
- Layers of Adrenal gland
- Cortex
- Hormones Secreted
- Glucocorticoids - Cortisol
- Produced in response to ACTH
- Normal physiology of ACTH
- Excess amount of ACTH released lead to Cushing Syndrome
- Cushing Syndrome
- What is it?
- A pituitary gland tumor (pituitary adenoma). A noncancerous (benign) tumor
of the pituitary gland, located at the base of the brain, secretes an excess
amount of ACTH, which in turn stimulates the adrenal glands to make more
cortisol. When this form of the syndrome develops, it's called Cushing disease.
- A pituitary gland tumor (pituitary adenoma). A noncancerous (benign) tumor
of the pituitary gland, located at the base of the brain, secretes an excess
amount of ACTH, which in turn stimulates the adrenal glands to make more
cortisol. When this form of the syndrome develops, it's called Cushing disease.
- Pathophysiology
- Signs and symptoms
- Women with Cushing syndrome
- Hirsutism
- Dysmenorrhea or Amenorrhea
- Hirsutism
- Men with Cushing syndrome
- Decreased libido
- Decreased fertility
- Erectile dysfunction
- Decreased libido
- General S & S
- Severe fatigue
- Muscle weakness
- Depression, anxiety and irritability
- Loss of emotional control
- Cognitive difficulties
- New or worsened high blood pressure
- Headache
- Bone loss, leading to fractures over time
- In children, impaired growth
- Severe fatigue
- Women with Cushing syndrome
- Risk factors
- Female
- 25-40 years old
- Exogenous (Cushing’s syndrome):
- Organ Transplant
- Chemotherapy (Long term use of steroids).
- Autoimmune diseases.
- Asthma.
- Allergies.
- Chronic inflammatory diseases.
- Obesity.
- Hypertension.
- Type II diabetes.
- Organ Transplant
- Female
- Diagnosis
- Epidemiology
- An estimated 10-15 per million people are affected every year.
- Pituitary adenomas (Cushing’s disease) account for more
than 70 percent of cases in adults and about 60-70
percent of cases in children and adolescents.
- Cushing’s syndrome most commonly affects adults ages 20-50
and is more prevalent in females, accounting for about 70
percent of all cases.
- An estimated 10-15 per million people are affected every year.
- Management
- Pharmacology
- Medications to control excessive production of cortisol at the adrenal gland include ketoconazole
(Nizoral), mitotane (Lysodren) and metyrapone (Metopirone).
- Mechanism of action
- Clnical use
- Replacement therapy
- Immunosuppressive Therapy
- Raised intracranial pressure
- skin diseases
- Cancer
- Acceleration of fetal lung maturation
- Replacement therapy
- Contradications
- Cushing’s syndrome
- Dibetes mellitus
- Heart failure
- Renal failure
- Cushing’s syndrome
- Adverse Effects
- Medications to control excessive production of cortisol at the adrenal gland include ketoconazole
(Nizoral), mitotane (Lysodren) and metyrapone (Metopirone).
- Surgery and its side effects
- Procedure
- To do this surgery, the neurosurgeon makes a small incision (cut) along the nasal septum.
Lateralization of the Middle turbinate, sphenoid ostium, Enlarging of the sphenoid ostium, sphenoid
sinus, partial Posterior vomer removal, The thinned anterior sella wall, Removal of the sphenoid
septum, Openning of the anterior sella wall, Incision of the dura, Cutting the soft tumor, Aspiration of
the tumor, Medial wall of the cavernous sinus, removal of what is left of tumor, repair.
- To do this surgery, the neurosurgeon makes a small incision (cut) along the nasal septum.
Lateralization of the Middle turbinate, sphenoid ostium, Enlarging of the sphenoid ostium, sphenoid
sinus, partial Posterior vomer removal, The thinned anterior sella wall, Removal of the sphenoid
septum, Openning of the anterior sella wall, Incision of the dura, Cutting the soft tumor, Aspiration of
the tumor, Medial wall of the cavernous sinus, removal of what is left of tumor, repair.
- Complications
- Sinus headache and congestion for up to a week or 2 after surgery.
- Brain damage, a stroke, or blindness if a nerve or artery is damaged
- Meningitis, infections, leakage of cerebrospinal fluid from the nose
- Diabetes insipidus
- Lack of pituitary hormones
- Sinus headache and congestion for up to a week or 2 after surgery.
- Procedure
- Pharmacology
- What is it?
- Cushing Syndrome
- Normal physiology of ACTH
- Produced in response to ACTH
- Mineralocorticoids - Aldosterone
- Androgens
- Glucocorticoids - Cortisol
- Hormones Secreted
- Medulla
- Hormones Secreted
- Stress hormones - Epinephrine & Norepinephrine
- Stress hormones - Epinephrine & Norepinephrine
- Hormones Secreted
- Cortex
- Anatomy of the adrenal gland
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