This paper provides a concise overview of Cushing's disease and Cushing's syndrome, two conditions caused by excessive cortisol in the body. It explains the distinction between the two diagnoses, outlines the normal role of cortisol and ACTH in the body, and describes the common symptoms, diagnostic procedures, and available treatments. The paper also discusses long-term prognosis, the historical context of the disease's discovery by Dr. Harvey Cushing, and the limited but meaningful progress made in surgical and medical management. It draws primarily on sources from the American Family Physician journal and the National Adrenal Diseases Foundation.
The paper effectively uses definition and classification at the outset to establish precise medical terminology. By differentiating "Cushing's syndrome" (medication-induced) from "Cushing's disease" (pituitary tumor-induced) before discussing symptoms and treatment, the author ensures that all subsequent analysis is conceptually grounded and accurate.
The paper opens with a definition of cortisol and its role in the body, then introduces both conditions and their distinction. It proceeds through symptoms, diagnostic methods, treatment protocols for each condition, prognosis, and closes with the history of the disease's discovery. This linear, topic-driven structure suits an informational health science paper well.
Cushing's disease, as well as Cushing's syndrome, is caused by the overproduction of a hormone called cortisol. Cortisol is "a normal hormone produced in the outer portion, or cortex, of the adrenal glands" (Margulies). Whether the body naturally overproduces this hormone or receives too much cortisol through steroid medications used to treat other diseases, the result can be the development of Cushing's disease.
In normal function, cortisol helps the body respond to changes and stressors. Its normal functions include the mobilization of nutrients, modifying the body's response to inflammation, stimulating the liver to raise blood sugar levels, and regulating the amount of water in the body (Margulies). Adrenocorticotrophic hormone (ACTH) is produced by the pituitary gland and regulates cortisol production. Overproduction of cortisol — or taking in excess amounts via medications — causes significant changes in "all of the tissues and organs of the body" (Margulies).
The culmination of these changes is what is typically labeled "Cushing's disease" or "Cushing's syndrome," depending on how the condition has developed. According to the American Academy of Family Physicians, "Cushing's syndrome" describes the condition when it results directly from the body's long-term exposure to excessive cortisol through medications. "Cushing's disease," on the other hand, is used for patients who develop the condition because of excessive cortisol production caused by a pituitary tumor (Kirk, 1119).
According to American Family Physician, some of the common symptoms of Cushing's disease and Cushing's syndrome include the following (Kirk, 1133):
Weight gain due to fat deposit formation around the stomach and upper back area. Thin skin that is easily bruised, with minor scrapes taking much longer to heal. Fatigue accompanied by weakness in the muscles of the upper body. Women may begin to experience irregular periods along with significantly thicker and more visible body hair. High blood pressure, osteoporosis, and diabetes can also be indicators of the condition.
Family doctors can usually diagnose patients with either Cushing's disease or syndrome. Diagnosis begins with a physical exam, during which the physician looks for the common physical characteristics of the illness. If the cause appears to be medications being used to treat other conditions — such as asthma, systemic lupus, severe allergies, inflammatory bowel disease, rheumatoid arthritis, and others (Margulies) — no further testing is usually required (Kirk, 1134).
Urine and blood tests are used to diagnose the disease in patients who are not taking any steroid medications. Some patients may need a CT scan or an MRI, which can reveal any tumors present (Kirk, 1134).
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