Is your appearance plummeting? Maybe you have this disease.

Is your appearance plummeting? Maybe you have this disease.

Recently, a woman became uglier and uglier in the past year.

Long-term menstrual irregularities

Go to the endocrinology department of the hospital

Diagnosed with rare disease - Cushing's syndrome

Source: Bailu Video

What is Cushing's syndrome?

Cushing's syndrome, also known as hypercortisolism or Cushing's syndrome, is a group of clinical syndromes caused by various causes, including long-term excessive secretion of cortisol (also known as glucocorticoids) by the adrenal cortex, which acts on target organs throughout the body. It was first discovered by American neurosurgeon Harvey Cushing in 1912.

Cushing's syndrome is relatively rare, with an annual incidence rate of about 2 to 3 million per million. The mortality rate is 4 times higher than that of the normal population. The male to female ratio is about 1:3, and symptoms usually appear between the ages of 30 and 60.

What are the symptoms of Cushing's syndrome?

Physical manifestations: mainly centripetal obesity. Obesity is one of the main symptoms of this disease and also the earliest symptom, forming the distinctive "full moon face" and "buffalo hump", and in the later stage, the hands and feet become slender.

Image source: Department of Endocrinology, Nanchang Third Hospital

Skin manifestations: acne on the face and chest, thin, greasy skin, purple lines under the armpits, sides of the abdomen, inner thighs, and inner upper arms, and hairy skin and ecchymosis.

In terms of male and female physiological functions: men may experience sexual dysfunction, and women may experience infrequent menstruation or amenorrhea.

Image source: Department of Endocrinology, Nanchang Third People's Hospital

Induce other diseases: high blood pressure, diabetes, fungal skin infections, osteoporosis, kidney stones, etc.; may also cause fatigue, psychological abnormalities, unexplained headaches, abdominal pain and other discomforts.

Image source: Adrenal Disease Center, West China Hospital, Sichuan University

What causes Cushing's syndrome?

The cause of Cushing's syndrome is mainly due to the abnormal increase in hormone secretion on the hypothalamus-pituitary-adrenal axis, which ultimately causes abnormal and large amounts of cortisol secretion, namely, corticotropin-releasing hormone (CRH) secreted by the hypothalamus, adrenocorticotropic hormone (ACTH) secreted by the pituitary gland, and cortisol (COR) secreted by the adrenal glands. The specific details are as follows:

Increased CRH secretion: This is rare and is mainly secreted by tumors in other parts of the body.

Increased ACTH secretion: pituitary tumor (most common), tumors in other parts of the body (such as lung cancer, pancreatic cancer, thyroid cancer, etc.).

Direct increase in adrenal cortisol secretion: adrenal cortical adenoma, adrenal cortical carcinoma, adrenal hyperplasia nodules, etc.; others include the use of large amounts of oral and topical glucocorticoids.

Image source: Department of Endocrinology, Nanchang Third People's Hospital

Who should be screened for Cushing's syndrome?

(1) Young patients develop clinical manifestations that are not commensurate with their age, such as osteoporosis and hypertension;

(2) Patients with clinical manifestations of Cushing's syndrome that progressively worsen, especially those with typical symptoms such as myopathy, erythema, purple striae, ecchymoses, and thinning of the skin;

(3) obese children whose weight increases but height percentile decreases, resulting in growth stagnation;

(4) Patients with adrenal incidentaloma;

(5) Those whose blood sugar or blood pressure is not well controlled.

Image source: Pexels

Once the diagnosis of Cushing's syndrome is confirmed, treatment should be started immediately. In terms of treatment methods, surgery is usually used for treatment, supplemented by radiotherapy. Drug treatment is often not ideal and is mostly used for postoperative recovery and short-term control.

References:

(1) Expert consensus on Cushing's syndrome (2011)

(2) Expert consensus on the diagnosis and treatment of Cushing's disease in China (2015)

Source: Peking Union Medical College Journal, Dingxiangyuan Secretion Time, Department of Endocrinology, Nanchang Third People's Hospital, Laboratory Medicine, Xuhui Health

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Editor: Muzi