Kimia Rajabi,1Saman Hakimian,2,*
1. Kimia Rajabi ,bachelor student of animal biology, Department of Biology, Faculty of Biological Sciences and Technologies, University of Isfahan, Iran 2. Saman Hakimian M.sc student of Pathogenic Microbes Islamic Azad University Central Tehran Branch
Introduction: Cushing’s syndrome is a life-threatening disease. This disease can appear both exogenously and endogenously. Its exogenous disease is caused by a glucocorticoid or adrenocorticotropin hormone (ACTH). If it is endogenous, it is caused by a latent increase in cortisol or ACTH.
CS can be ACTH dependent or not. research has shown that more than 20% of adults with CS are non-ACTH dependent. This is also the case for about 15% of children over the age of seven. Symptoms of CS include such as: cracked skin or striae(mostly seen on the sides, thighs and armpits), roundness of face and neck, visceral obesity, acne, bruising, swelling, short stature, hirsutism, hypercortisolism, hyperglycemia, increase LDL, decrease HDL, hypertension, hypercoagulability, osteoporosis, depression, fatigue, cognitive disorders, weight gain, proximal muscle weakness, adrenal and pituitary tumors, menstrual disorders, infection(skin infection, urogenital infection and etc ), etc. the most common visual symptoms in CS are weight gain and BMI increase(BMI>30). which helps doctors in the initial diagnosis of the disease by observing these symptoms.
this disease is followed by diseases such as diabetes, heart attack and stroke, thromboembolism. hypertension, thromboembolism and infection are the main causes of death in this disease.
Methods: Excessive increase in glucocorticoid plays significant role in this disease. glucocorticoid affects both inflammatory proteins and the immune system. Salivary cortisol is more common in patients with ACTH dependent. even a slight increase in cortisol can cause hypertension, and hypertension usually persists after treatment.
Of course, this disease is less common in children and sometimes may be seen in infants, and also in patients with CS, the probability of pregnancy is very low. Pregnant women with CS have high cortisol, high blood pressure and skin cracks and are at high risk of death.in pregnant women with CS, there is a risk of miscarriage, premature birth, and intrauterine growth restriction. Due to physiological changes in pregnancy, the diagnosis of CS is difficult and complicated.
Bone changes in this disease affect the physical and functional structure of the body.30% to 40% of patients suffer from bone fractures and 50% have osteoporosis. Their growth can fail. It leads to a decrease in bone mass and short stature in adulthood. the focus of osteoporosis is more on the spine. of course, it affects the ribs and long bones.
hypertension is the most common symptom, affecting about 80% of people with CS. It increases cardiac output and increases peripheral vascular resistance.
Infection of viruses such as HPV, Herpes Zoster, COVID-19, etc. are more effective in this patients.
Pituitary adenoma is a common intracranial symptom In CS that is a sign of benign. 25% to 35%pituitary adenoma is an invasive factor and has a profound effect on the secretion. the internal tumors of these patients are usually more than one centimeter long and the size of the tumors may not change annually.
Results: thrombosis is one of the most important symptoms, which is related to the age of individuals and occurs more in women than men. increases coagulation and fibrinolactic.so coagulation inhibitors are needed.
Conclusion: however, some factors cause an increase in false cortisol, such as mental and physical stress, chronic and acute obesity, pregnancy, chronic exercise, depression, alcohol, anxiety, drinking more than 5 liters of water a day, malnutrition, smoking and drug use.