From the Guidelines
Cushing syndrome symptoms include weight gain, high blood pressure, high blood sugar, muscle weakness, and mood changes, among others, which occur due to prolonged exposure to high levels of cortisol 1.
Common Symptoms
- Weight gain, particularly in the face (moon face), abdomen, and upper back (buffalo hump)
- Purple stretch marks on the abdomen
- Reddish-purple facial skin
- Easy bruising
- Excessive hair growth in women
- High blood pressure
- High blood sugar
- Muscle weakness
- Bone loss
- Fatigue
- Mood changes, including depression and irritability
- Poor wound healing
- Irregular menstrual periods in women
- Decreased libido and erectile dysfunction in men
Causes and Complications
These symptoms are caused by excess cortisol, which can result from taking corticosteroid medications, a tumor in the pituitary gland (Cushing's disease), or tumors in the adrenal glands or elsewhere that produce cortisol 1. Recognizing these symptoms early is crucial, as untreated Cushing syndrome can lead to serious complications, including diabetes, heart disease, and bone fractures. Early diagnosis and treatment are essential to prevent long-term quality of life (QoL) impairment, particularly in patients with Cushing's disease 1.
From the FDA Drug Label
Signs and symptoms of Cushing's syndrome in both cohorts Individual patients showed varying degrees of improvement in Cushing's syndrome manifestations such as cushingoid appearance, acne, hirsutism, striae, psychiatric symptoms, and excess total body weight The symptoms of Cushing's syndrome include:
- Cushingoid appearance
- Acne
- Hirsutism
- Striae
- Psychiatric symptoms
- Excess total body weight These symptoms can vary in severity and presentation among individuals with Cushing's syndrome 2.
From the Research
Cushing Syndrome Symptoms
- Cushing syndrome is characterized by a prolonged increase in plasma cortisol levels, leading to various symptoms such as:
- Hyperglycemia
- Protein catabolism
- Immunosuppression
- Hypertension
- Weight gain
- Neurocognitive changes
- Mood disorders 3
- Skin changes are also common, including:
- Facial plethora
- Easy bruising
- Purple striae 3
- Metabolic manifestations may include:
- Hyperglycemia
- Hypertension
- Excess fat deposition in the face, back of the neck, and visceral organs 3
Diagnosis and Treatment
- Evaluation of patients with possible Cushing syndrome begins with ruling out exogenous steroid use, followed by screening for elevated cortisol levels 3
- Treatment typically involves surgery to remove the source of excess endogenous cortisol production, followed by medication such as adrenal steroidogenesis inhibitors, pituitary-targeted drugs, or glucocorticoid receptor blockers 3, 4
- In some cases, radiation therapy and bilateral adrenalectomy may be necessary 3, 5
Specific Conditions
- Cushing's disease, caused by a pituitary tumor secreting corticotropin, is a common form of endogenous Cushing syndrome, accounting for approximately 70% of cases 5
- Adrenally directed medical therapies, such as ketoconazole and metyrapone, may be used to inhibit adrenal steroidogenesis in patients with Cushing syndrome 4