Cushing’s syndrome (CS) is a rare difficulty caused when ns adrenal gland(s) renders too lot of a hormone referred to as cortisol. CS is most frequently due to der tumor or mass uncovered in ns pituitary gland, however can likewise be caused by tumors in a adrenal glands themselves.

Você está assistindo: Para que serve o exame de cortisol

People com Cushing"s syndrome might see their enfrentar get round ("moon face"), they get weight in inexplicable ways, bruise conveniently or feel weak, tired e sad. Women e men might also notice fertility and other problems. CS is many often uncovered in adult between a ages the 20 e 50.

What happens Under normal Conditions?

The adrenal glands estão found over each kidney. They ~ ~ triangle-shaped, e measure about fifty percent an inch in height e 3 inches in length. Each adrenal gland has 2 layers.

The adrenal medulla (inner part) renders epinephrine (also referred to as adrenaline).The adrenal cortex (outer part) provides steroid hormones (such as cortisone e aldosterone).

The adrenal glands direção many procedures in a body. Their job is to guarda the corpo in balance by making various hormones that ~ ~ critical for maintaining good health.


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These hormones são de many important things. Para example, they help regulate fluid e salt level in the corpo that affect blood volume and blood pressure. Castle also aid the body react to stress e change. Castle cause a faster love rate e boost other systems that help you to react easily with a burst of energy when needed. Troubles in the cortex or ns medulla, then, can result in high blood pressure.

Cortisol levels estão controlled by a pituitary gland, i m sorry is found at the base of the brain. The hypothalamus of a brain makes the corticotropin-releasing hormone (CRH). CRH tells a pituitary gland to relax signals that ao controle how lot cortisol ns adrenal glands make. A pituitary gland signal is referred to as corticotropin or adrenocorticotropic hormone (ACTH).

The pituitary detects when cortisol levels estão high enough, then it stops sending out signals. This feedback sistema acts like naquela thermostat come balance cortisol levels. The is highly managed system.


The indicators of CS appear slowly end time. Some world may apenas um have der few signs while others concertos greater changes. Common symptoms that CS are:

"Moon face" (round and full face)"Buffalo hump" (fat bulge between ns shoulders)Gaining weight about your bellySkin becomes thin. You may bruise easily e find pink or purple stretch marks on her bellyHigh blood pressureHigh blood sugarFatigue e trouble sleeping (cortisol is exit based on normal sleep patterns)Mood swings e sadnessLack of muscle strength (difficulty standing increase from naquela seated position)Bone thickness lossSexual abnormalitiesMore corpo hairMenstrual transforms in womenWomen may also see your appearance change and become more masculine (virilization)

The indications of CS often appear slowly. Der series of retratação of naquela person’s appearance may be a best rua to show the changes.

Doctors sometimes explain patients com CS as having "Cushingoid" features. These features estão also lado effects the cortisone connected drugs such together prednisone and prednisolone.


light Pituitary Tumor (Adenoma)

This is a most common reason of CS. Practically 75 out of 100 come 85 fora of 100 tudo de Cushing"s syndrome cases ~ ~ this type. Corticotropin (CRH) is generally made by a pituitary gland. It is naquela hormone that stimulates a adrenal gland to release cortisol, specifically in equipe of stress. Der pituitary tumor reasons too lot corticotropin (also referred to as ACTH) to it is in made. ACTH is naquela kind the pituitary ao controle switch the manages ns growth e activity of a adrenal glands. Too lot corticotropin causes the adrenal gland to make too lot cortisol. Too lot cortisol can reason CS.

Adrenal Tumor

This important reason of CS is when der tumor is uncovered in ns adrenal gland. The tumor might or may not it is in cancerous.

Ectopic (Abnormal) ACTH

This is when CS is led to by tumors that make ACTH in various other organs. For example, tumors found in the chest on a lung or thymus deserve to make ACTH.

Steroids

Steroids that estão used at alto doses and for long periods of time may reason CS. Para example, a use the prednisone.

It is normal to find high levels the cortisol in the corpo humano from stress. This go not bring about Cushing"s syndrome.

In an extremely rare cases, there is a hereditary link to an endocrine tumor the could cause CS. Most cases of CS ser estar not passed down.


The signs ser estar hard to see and may be masking by other wellness problems. You will should see your health care provider come find out if CS is naquela possibility. Der diagnosis is based on:

Your health and wellness historyA physical examLab tests ao cortisol level
Dexamethasone Suppression Test

Dexamethasone (steroid) pill is given by mouth for this test. Then blood is gathered to measure up cortisol levels in the body. Normally, the sub steroid would make the corpo humano stop do cortisol. In a person com CS, ns levels of cortisol will certainly stay really high.

24-Hour Urinary cost-free Cortisol Test

Urine trial and error is periodically used to test cortisol levels. Urine samples ~ ~ collected for a full period of 24 hours, e tested. Come diagnose adrenal problems, much more tests would certainly be needed.

Further Tests

Once CS has been diagnosed, imaging and other tests may be provided to find the cause. Blood tests e imaging tests can discover unwanted tumors. In blood tests, physicians will look for:

Very short levels that corticotropin, which says an adrenal tumor. CT scan or MRI commonly confirms the diagnosis.Slightly high levels of corticotropin, i m sorry suggests der pituitary tumor. MRI of ns brain can regularly confirm this diagnosis. More tests may be needed if the pituitary tumor is too tiny to be seen com an MRI.Very high levels the ACTH imply an ectopic ACTH. Much more tests would be required to confirm this.Imaging Tests

A CT scan or MRI deserve to often find pituitary or adrenal tumors. This tests show different views of the corpo in detail. They ser estar painless, accurate and quick.


Treatment counts on what is causing the excess cortisol. If ns cause is são de steroid usar over time, your doutor may tell you to stop taking ns drug or provide you less. If a cause is naquela benign or cancer adrenal tumor, girlfriend will require surgery to remove it.


If resulted in by Steroid Use

Often, stopping ns use of drugs favor prednisone will enable the body to go ago to normal. But, to cut or stop steroid usar depends on the type of condition being treated and how your corpo reacts.

If led to by a Pituitary Tumor

Pituitary tumors deserve to be treated com surgery. Commonly an operation have the right to be done through a nose (transsphenoidal surgery) by naquela neurosurgeon.

If brought about by one Adrenal Tumor

Adrenal tumors can be removed by naquela urologist. When ns adrenal tumor is little (less 보다 4-6 cm), a tumor is much more likely not cancer. It deserve to be eliminated with naquela small cut through laparoscopic or robotic surgery. Sometimes part of the adrenal gland is eliminated (a partial adrenalectomy) to leave a healthy portion of ns gland behind. When laparoscopic surgical procedure is no possible, one “open” operation is used. Open surgery is used para larger or more complicated tumors. If a mass is larger than 4-6 cm, the is much more likely to it is in cancer. Nearby organs (the spleen, kidney or a part of ns colon) may also need come be gotten rid of or decreased to remove ns entire tumor.


How fine you feel after treatment, is connected to ns cause of overfill cortisol. Treatment mostly helps patients feel better and can frequently cure a problem. In an extremely rare situations of adrenal cancer, much less than 50 fora of 100 world will it is in cured. However, a most important thing to understand is the treatment porque o an adrenal adenoma (non-cancerous tumor) is really successful.


Overall, a quality of life for a person with CS relies on:

How much extra cortisol is in your systemHow grande the condition has lastedHow healthy you ~ ~ in generalHow easily a type of CS deserve to be cured

If CS is cured, tudo of the symptoms of the disease will certainly go away. This may take as grande as 2 to 18 months after treatment. A slow improvement can be hard to take, but you will feel better. Together you improve, you will certainly need frequent calls e visits to her health care provider.

If a CS is no curable, or if you still have actually CS from steroids, friend may have to cope with a signs pointed out earlier. (Things like: fatigue, muscle weakness, abdominal e facial load gain, depression, the atmosphere swings.) Drugs have the right to help com these ongoing symptoms. You will need regular visits to your health treatment provider porque o exams, blood tests, e treatment of side effects.

After Adrenal Tumor Surgery

Most world feel far better quickly ~ laparoscopic surgery. Girlfriend can often leave the hospitais within one or 2 dia with no restrictions. Frequently patients feel back-to-normal in around 3 come 5 weeks. Recovery são de open surgical procedure will pegue longer. You might stay in the hospitais between 5 e 10 days. Full healing takes up to 8 weeks.

When uma adrenal gland offers off too lot cortisol, ns other gland might shut-down. After surgery, you may need steroids to avoid der deficiency while the gland recovers. This may remover up to a year. Rarely a adrenal gland the shut-down won"t recover. In this case, steroids might be needed as instead of therapy.

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It"s vital to understand that adrenal surgical treatment is complex. It help to choose naquela surgeon who has significant experience com surgery in the area around a kidneys and adrenal glands. Falar with naquela few surgeons before you choose uma to job-related with.


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