The difference between Cushing’s disease and Cushing’s syndrome | Cushing’s disease

The difference between Cushing’s disease and Cushing’s syndrome

Cushing’s syndrome includes all diseases or changes associated with elevated cortisol levels. It makes no difference whether the cortisol, for example, was supplied externally, i.e. by medication, or whether it was caused by an overproduction of cortisol in the body itself. The Cushing’s syndrome thus describes a hypercortisolism, which can have various causes.

Cushing’s disease, on the other hand, refers explicitly to an increased cortisol level, which is caused by an increased ACTH production, mostly in the context of a pituitary gland tumor. Both terms usually cover the same symptoms.Cushing’s disease can also affect the sex hormones, especially the male hormones (androgens). Overproduction can lead to disturbances in the menstrual cycle, especially in women, and to increased masculine hair growth, especially on the face.

The course of the disease

Cushing’s disease usually presents with the symptoms mentioned above. In the context of a pituitary gland tumor, these occur either suddenly or also insidiously. This is related to how fast the tumor grows and how cortisol production is affected.

If cortisol levels are very high, the cardiovascular system can be strongly influenced. Patients with high cortisol levels often also show abnormally high blood pressure. In the long term, this promotes diseases such as a heart attack or a stroke.

This is why introductory therapy measures are so important. In the surgical removal of a tumor, the ACTH-over-producing cells are removed and the affected patients usually have normal cortisol levels again after the operation – they are therefore considered cured. If surgery is not an option, the cortisol level can be reduced with medication, for example, which also alleviates the symptoms and reduces the unwanted negative influence on the cardiovascular system. The further course of the disease in drug-adjusted patients cannot generally be predicted across the board, as it is also influenced by other factors such as underlying diseases or age.