Cushing’s Disease and Cushing’s Syndrome (Pediatric)

What are Cushing's disease and Cushing’s syndrome?

Cushing's disease results from excessive production of corticotropin releasing hormone in the hypothalamus , or adrenocorticotropin hormone (ACTH) in the pituitary gland, which occurs due to a growth in these glands.

Cushing’s syndrome results from excessive production of ACTH outside the brain, and of cortisol in the adrenal gland. It also result from long-term glucocorticoid therapy to reduce inflammation.

What are the symptoms of these disorders?

Symptoms include poor growth, excessive weight gain, unusual fat distribution, acne, excessive face and body hair (hirsutism), purple stretch marks, high blood pressure and diabetes mellitus (a deficiency of the pancreatic hormone, insulin).

How are these disorders diagnosed?

Cushing's disease is the medical cause of Cushing's syndrome. And both conditions are difficult to diagnose.

Several tests may be needed to identify excess glucocorticoid, including a 24 hour urine test, a saliva test performed at midnight, and a blood test performed after taking a steroid pill the night before.

If these tests are positive further evaluation may be necessary to distinguish Cushing's disease from Cushing's syndrome.

How are these disorders treated?

Cushing’s disease can be treated by surgery. The purpose of this surgery is to remove an ACTH-producing growth from the pituitary gland.

Cushing’s syndrome may be treated by slowly discontinuing glucocorticoid medications or by the removal of a tumor that is producing ACTH or cortisol.