Round “full moon face”

A round full moon face is a common symptom of Cushing’s syndrome. The marked change in the shape and features of the face is the main focus of attention and places a particular psychological burden on those affected. The typical round face is noticeable with distinct chubby cheeks and an implied double chin and reddened cheeks.

The increase in volume is due to the side effects of glucocorticoids. In addition to their effect on the immune cells, they also affect the electrolyte balance, which is in interaction with the water balance. The imbalance of the components ensures that more fluid is stored in the tissue. The optical effect is a “bloated” looking face.

Muscular atrophy: very thin arms and legs

Thin arms and legs are due to the side effects of glucocorticoids on the metabolism. They also influence the metabolism of proteins. Proteins are nothing other than proteins and are mainly found in muscle tissue.

Glucocorticoids have the side effect of increasing the breakdown of proteins. Thus, the muscle mass decreases with the continuation of the therapy until it shows up in thin arms and legs. However, glucocorticoids do not lead to a complete loss of muscle strength.

Muscular weakness

The muscle weakness in Cushing’s syndrome is caused by the increased muscle loss under therapy. Depending on the individual case, both the number of muscle cells can decrease and their cell structure can change. In detail, this means that existing muscle cells also deteriorate in their performance.

Those affected notice this in a faster fatigue in stressful situations and possibly in a feeling of weakness. The drop in performance can vary depending on the previous training status. Continued physiotherapy or independent training units can have a positive influence on the extent of muscle loss. Physical activities, however, cannot completely prevent muscle atrophy.

Bone loss (osteoporosis)

The change in bone structure is a very late phenomenon in Cushing’s syndrome. It is also a symptom that is not always reversible in its consequences by discontinuing medication. The development of osteoporosis under glucocorticoid therapy is due to the influence on the filtering function of the kidneys.

Glucocorticoids act on the channels and transporters in the cell membranes of the kidney and thus lead to an increased excretion of calcium. To compensate for the loss, calcium is mobilised from the bones. Since the degradation of regeneration is predominant in this process, the healthy bone structure shrinks. However, it often takes years before skeletal abnormalities become apparent. Which could also be of interest to you: Preventing osteoporosis

Bluish-red stripes on the trunk of the body, wider than 1 cm (stretch marks)

Bluish-red stripes on the trunk of the body can often be found preferentially on the flanks and around the navel in Cushing’s syndrome. This is because it is in these areas that the skin is usually most stressed. It does not matter whether the strain is caused by movements, touching or by the lying on of clothes.

In addition, these areas are predestined for an increased accumulation of fatty tissue, which puts additional strain on the elasticity of the skin. If glucocorticoids are administered in higher dosages, they cause a permanent atrophy of the skin. The elasticity of the skin thus decreases and both its structure and thickness change. Visually, this can be seen in bluish-red stripes which have their color from the blood vessels directly under the skin. A regression cannot be expected after the end of the therapy.