19Feb

Disease of Itenko-Cushing - symptoms, diagnosis and treatment

Changes Clinical picture
Skin Excessive dryness, thinning, peeling, "marbling" or dyschromia - pronounced vascular pattern in the form of a network or tree, having a red-cyanotic hue. In addition to all this, the patient notes increased regional sweating.

Also worth noting is the appearance on the skin of a characteristic symptom of this disease - striae. These are large or small stretches of dark red or crimson color that are located on the abdomen, the external femoral surface, the chest and sometimes in the shoulder area.

Because of the increased greasiness of the epidermis, acne-inflamed acne can appear.

Increased fragility of the vessels often causes subcutaneous hemorrhages, which take a pattern in the form of asterisks.

Muscular system There is a decrease in muscle mass up to atrophy. There is also a decrease in muscle tone, especially in gluteus muscles( visually they "flow" from the back of the thigh to the back).The anterior abdominal wall is also subject to changes: because of the weakness of the muscles, protrusion and abruptness of the abdomen occur, which subsequently often leads to a hernia.

This pathology occurs due to the high concentration of the glucocorticoid hormone, which negatively affects the proteins that fill the muscle mass.

Hair and sexual characteristics Development of hirsutism and virilism is observed. These conditions arise from the overabundance of the androgen hormone. Hirsutism is the growth of hair in the weak half of mankind according to the male type, that is, the appearance of vegetation under the nose and lower lip, on the chest and back. Virilism also indicates a pathology, and in a woman this is reflected in a change in the voice( it becomes gross and low).In addition, atrophy of the mammary glands, ovaries and uterus occurs, and in severe cases, the growth of the clitoris and the fusion of the labia are noted.

The presence of the androgen hormone in men is the norm, but its overabundance leads to the intensity of the above symptoms: excessive hairiness throughout the body, an increase in the size of the prostate and external genitalia.

Obesity This sign is the most leading in the formulation of a visual diagnosis, because the intensive development of subcutaneous fat in the disease of Itenko-Cushing is almost always observed. The distribution of weight has its own peculiarity and this is the main prompt for the diagnosis.

The formation of fatty tissue on the lower and lateral parts of the face contributes to its rounding and in medicine it is called as "moonlike face".Also, the development of subcutaneous lipid mass is observed on the posterior surface of the neck( level of the seventh vertebra of the cervical region), on the abdomen and thighs.

Pathological obesity occurs due to the increase in the level of the hormone cortisol, which is produced by the adrenal glands.

Skeleton Because of the pathological level in the blood of the glucocorticoid hormone, there is an inadequate absorption by the intestine of such an essential trace element as calcium. This adversely affects the skeleton and further leads to its insufficient hardness and even destruction. The most deficiency of calcium is reflected on large tubular bones, cranium and vertebral column. So, in adults there is a decrease in growth, and in children - a delay and even a halt.

There is a tendency to fracture.

Respiratory organs There is a decrease in immunity, which leads to frequent colds. Often there are bronchitis, pneumonia;risk group for tuberculosis.
Heart and blood channel The blood pressure rises, heart failure develops. Often there is pain and heaviness in the chest.

Nervous and mental disorders Headache is noted, as well as unpleasant sensations in the upper and lower extremities, back.

From the side of psychoemotional background: memory disorders, speech, frequent apathetic and depressive states. Abrupt overexcitation can be changed by inhibition. Suicidal tendencies.

Other endocrine disorders Each third patient has diabetes mellitus. Very often there is sexual and reproductive dysfunction: a woman - a lowered attraction to a partner, lack of menstruation, miscarriage of the fetus.

Symptoms of Itenko-Cushing

Disease of Itenko-Cushing( hypercorticoidism) is a neuroendocrinal disease that arises from a disturbance of the regulatory function at the level of the brain in the hypothalamus and pituitary gland. This defeat leads to their intensified work, as a result of which there is an increased production of adrenocorticotropic hormone.

Endocrine abnormalities in the brain affect the function of the adrenal cortex, so there are unfavorable failures in the production of hormones cortisol and cortisone.

Symptoms of Itenko-Cushing's disease

There are a lot of clinical features in this disease. Due to the dysfunction of the hypothalamus-hypophyseal system, pathological changes are observed in many systems. So, what is the manifestation of Isenko-Cushing's disease?

Photo of Symptoms of Itenko-Cushing

Photo of symptoms of the Itenko-Cushing disease: a) moonlike face;b) striae on the abdomen.

All of the above symptoms do not always indicate a severe neuroendocrine disease. To clarify the diagnosis, a full examination with a specialist is recommended.

Diagnostics of

It is very important to ask for help in finding suspicious symptoms on time! Some signs of the disease may take the form of a "time bomb" and eventually lead to disability and even death.

The diagnosis is based on the following indicators:

  • visual inspection - the study of symptoms and complaints;
  • blood and urine analysis for the study of hormones or their final products;
  • X-ray of bones, magnetic resonance and computed tomography, ultrasound diagnosis of internal organs;
  • diagnostic test with the preparations "Metopirone" and "Dexamethasone".

Treatment of

Treatment is an important step in solving the problem. It is based on the following principles:

  • removal of the adrenal glands surgically or their internal destruction by the introduction of a special contrast agent;
  • in the presence of a pituitary tumor, a removal operation is performed;
  • radiation, chemical and hormone therapy in benign and malignant formations;
  • dopamine receptor agonists;
  • treatment of secondary diseases - diabetes, osteoporosis, reproductive dysfunction.
There is such a thing as medical hypercorticism. It occurs due to the disorderly reception of hormonal drugs, the main active ingredient of which is Prednisolone, Hydrocortisone, Betamethasone or Dexamethasone.

In fact, Itenko-Cushing's disease is rare. Experienced doctor probably recognizes it even on external manifestations, however, to confirm the diagnosis and choose the tactics of treatment, it is recommended to pass laboratory tests and undergo a complete examination.