Skin condition, body weight, cardiovascular system work and other physiological parameters are regulated by hormones. They are produced by special glands - the adrenal glands and the pituitary gland. If the functioning of the organs is disrupted, endocrine imbalance occurs.
Isenko-Cushing syndrome - what is it?
The described condition (hypercorticosis) is a group of pathologies in which the adrenal cortex produces an excessive amount of cortisol or adrenocorticotropic hormone. It is important to distinguish between the problem under consideration and Cushing's disease. It is a secondary lesion of the endocrine system, developing against the background of diseases of the hypothalamus and the pituitary gland.
Cushing's Syndrome - Causes
There are several factors that presumably provoke this pathology. All causes of hypercorticism are conventionally classified into 3 types:
- exogenous;
- endogenous;
- functional.
Exogenous hypercorticosis
This syndrome of Itenko-Cushing develops under the influence of external factors. The main cause of its occurrence is the continued use of glucocorticosteroid hormones. This kind of syndrome is caused by therapy, therefore it is also called iatrogenic hypercorticism. It is often observed after transplantation - hormonal preparations are prescribed to suppress immunity and prevent rejection of the transplanted organ. Medical hypercorticism also begins with the treatment of chronic inflammations:
- rheumatoid arthritis;
- bronchial asthma;
- systemic lupus erythematosus.
Endogenous hypercorticosis
This variant of the disease occurs due to internal disorders in the body. The main causes of development are conditions leading to dysfunction of the adrenal cortex:
- hyperplasia ;
- cancer;
- benign neoplasm;
- dystrophy.
To provoke the growth of adrenal tumors can be heredity, so one of the factors of the emergence of hypercorticism is a genetic predisposition. Itenko-Cushing's disease is also caused by neoplasms, but in other organs:
- pituitary gland;
- ovaries;
- light;
- thymus;
- testicles;
- pancreas or thyroid gland;
- bronchi.
Cushing's pseudo-syndrome
There are conditions in which excess cortisol production occurs, but there are no hormone-secreting tumors in the body. This is a functional syndrome of hypercorticism, it often accompanies neurological and mental pathologies. For violations characterized by a clinical picture, completely identical to the true disease. Sometimes pseudo-syndrome Itenko-Cushing provoke:
- obesity;
- pregnancy;
- alcoholism (chronic intoxication);
- hypertension ;
- violations of carbohydrate metabolism.
Illness of Itenko-Cushing - symptoms
The main feature of hypercorticism is the deposition of fat in several areas:
- neck;
- head;
- stomach;
- chest.
Because of obesity, it is even visually easy to identify the Itenko-Cushing syndrome, the symptoms of which are as follows:
- round face;
- disproportionately thin limbs in comparison with the body;
- purple-blue stretches on the buttocks, hips, abdomen, shoulders;
- depression and psychosis due to excess weight and unsatisfactory appearance.
In the absence of treatment, the hormonal background deteriorates rapidly. Developing progressive Cushing's syndrome, the symptoms of which are:
- excess hair growth in women (hirsutism in the male type);
- high blood pressure;
- menstrual cycle disorders;
- impotence;
- myopathy;
- osteoporosis and associated with it frequent fractures of bones;
- headache;
- insomnia;
- mental disorders;
- weakness;
- amyotrophy;
- abdominal hernia;
- sweating;
- acne ;
- hyperpigmentation of some skin areas;
- rachiocampsis;
- abnormal abdominal muscles;
- decreased activity of the immune system;
- bright blush.
Isenko-Cushing syndrome - diagnosis
The main factor that allows to suspect hypercorticism is the symptoms of pathology. After collecting anamnesis and a thorough examination, the endocrinologist assigns a series of studies to determine the causes of clinical events, the differentiation of the described disease and other disorders. Cushing's syndrome - diagnosis:
- the analysis of urine and blood on the content of corticosteroid hormones;
- radiography of the region of the Turkish saddle and skull;
- computer or magnetic resonance imaging of the pituitary and adrenal glands;
- dexamethasone samples;
- biochemistry of blood;
- X-ray of the spine and thorax;
- scintigraphy of the adrenal glands.
Isenko-Cushing syndrome - treatment
Therapeutic tactics depend on the causes that triggered hypercorticism. With exogenous factors, gradual cancellation, reduction of the dosage of glucocorticoids or their replacement by other immunosuppressive drugs is recommended. In parallel, symptomatic treatment of the Itenko-Cushing's disease, aimed at restoring metabolic processes and normalizing body weight, is carried out.
In the case of the endogenous origin of excessive cortisol production, its cause must be eliminated. The only effective option in the presence of tumors that provoke Cushing's syndrome is surgically treated. Neoplasm is removed, followed by radiation and prolonged drug therapy. Select pharmacological agents that reduce the concentration of corticosteroid hormones in the blood and suppress their production:
- Mitotane;
- Aminoglutethimide;
- Mammoth and others.
In addition, it is necessary to stop the symptoms of pathology. To do this, use (at the choice of the endocrinologist):
- preparations of potassium;
- antihypertensive drugs;
- diet;
- vitamins and minerals;
- hypoglycemic medicines;
- calcitonins;
- bisphosphonates;
- anabolic steroid;
- sedatives;
- antidepressants.
Nutrition for hypercortisy
Diet does not help significantly reduce the production of cortisol, but will ensure the normalization of metabolic processes in the body. It is important to complexly suppress hypercorticism - treatment necessarily involves correction of the diet with the restriction or exclusion of the following products:
- margarine;
- animal fats;
- mayonnaise;
- butter;
- smoked products;
- salt;
- fatty meat and fish;
- baking;
- marinades;
- pickling;
- strong tea and coffee;
- alcohol;
- sweets.
To facilitate the Itzenko-Cushing syndrome it is important to use:
- eggs;
- dairy products;
- hard cheese;
- low-fat or vegetarian soups;
- porridge;
- boiled dietary meat;
- fruits and vegetables;
- greenery;
- herbal teas;
- non-acid compotes and fruit drinks.
Complications of Itenko-Cushing's disease
The pathology considered is prone to progression, in the absence of adequate therapy it can lead to serious consequences. The disease and the Itenko-Cushing syndrome are associated with such complications:
- stroke;
- decompensation of cardiac activity;
- sepsis;
- chronic renal failure;
- severe pyelonephritis;
- phlegmon;
- multiple fractures of bones;
- irreversible damage to the spine;
- furunculosis;
- formation of kidney stones;
- Fungal and bacterial skin lesions with suppuration;
- miscarriage;
- complicated delivery.
Sometimes a syndrome or a disease of Itenko-Cushing causes an extremely dangerous condition that can end lethal - adrenal (adrenal) crisis. Its signs:
- hypoglycemia;
- acute pain in the abdomen;
- indomitable vomiting;
- hyperkalemia;
- loss of consciousness;
- a sharp drop in blood pressure;
- hyponatremia;
- metabolic acidosis.