Difference Between Cushing Syndrome and Cushing Disease
Cushing Syndrome vs Cushing Disease: Key Differences & Causes Meta
Cushing syndrome is a disorder with physical and mental changes that occur due to an excess level of cortisol in the blood for a longer period. On the other hand, Cushing's disease is a rare condition that affects only 10 to 15 people per million every year. It is more common in women between the ages of 20 and 50.
All cases of Cushing Disease are Cushing Syndrome, but not all Cushing Syndrome cases are Cushing Disease.
Key Differences Between Cushing Syndrome and Cushing Disease
Here are the key differences between Cushing syndrome and Cushing disease:
| Aspect | Cushing Syndrome | Cushing Disease |
| Definition | This condition happens due to an excess level of cortisol in the body. | It is a specific form of Cushing syndrome that occurs due to the ACTH hormone. |
| History | ● Exogenous corticosteroid use is the main cause of Cushing syndrome. ● Adrenal carcinoma are the endogenous cause of this disorder. | ● Pituitary disorders are the most common cause of this disease. |
| Symptoms | Both Cushing syndrome and Cushing disease have similar symptoms ● Weakness ● Weight gain ● Depression ● Insomnia ● Irregular Periods ● Central weight gain ● Fatigue ● Mood swings/depression ● Decreased libido ● Menstrual irregularities | |
| Warning Signs | Both Cushing syndrome and Cushing disease have similar signs: ● Moon face ● Purple striae ● Buffalo hump ● Hypertension ● Hirsutism ● Proximal muscle weakness. ● Osteoporosis ● Hyperpigmentation ● Skin thinning and bruising ● Central obesity ● Moon face | |
| Diagnosis | ● 24-hour urinary free cortisol ● Late-night salivary cortisol ● Low-dose dexamethasone suppression test | |
| Differentiation Tests | ● Low ACTH → Suggests adrenal cause (Cushing Syndrome from adrenal tumor or exogenous steroids) ● CT of Chest/Abdomen: Looks for ectopic ACTH-producing tumors or adrenal masses → supports Cushing Syndrome | ● High or Normal ACTH → Suggests ACTH-dependent cause (could be Cushing Disease or ectopic ACTH production) ● MRI of Pituitary: Detects pituitary adenoma → confirms Cushing Disease ● IPSS - Central ACTH gradient present |
What are the risk factors of Cushing syndrome and Cushing disease?
There are some risk factors for Cushing syndrome and Cushing disease. In the following section, we will discuss some of these:
- Glucocorticoid Metabolism : Long-term use of glucocorticoid medications (like prednisone) for conditions like autoimmune disease or inflammatory conditions can lead to these disorders. This is also known as exogenous Cushing’s syndrome.
- Pituitary Tumours : Tumour development in the pituitary gland can cause Cushing syndrome. This mainly affects women, and due to tumour formation, it triggers the excess production of cortisol. Though both glands are present in both genders, women are more prone to developing this condition.
- Age : Cushing's syndrome, or Cushing's disease, is more prevalent in adults, especially those who are between 30 and 50 years old. Sometimes, it can affect children due to certain genetic mutations.
- Gender : Women are about three times more likely to develop Cushing syndrome than men. This happens due to the higher prevalence of adrenal tumours, particularly adenomas, in women.
- Family History : If anyone in the family has mutations in the genes, like Multiple Endocrine Neoplasia type 1 (MEN1) or Carney complex, it can increase the likelihood of developing Cushing’s Syndrome. These mutations lead to tumour formation in the pituitary and adrenal glands.
Sometimes, individuals with poorly uncontrolled type 2 diabetes and high blood pressure can increase the risk of the development of Cushing’s syndrome.
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