Cushing Syndrome: Causes and Symptoms

What is Cushing syndrome?

Cushing syndrome is a rare disorder in which the adrenal glands (small glands on top of the kidneys) make too much of a hormone called cortisol.

In normal amounts, cortisol (sometimes called the stress hormone) helps the body respond appropriately to stress. Cortisol also helps maintain blood sugar levels and blood pressure. In children, too much cortisol can cause poor growth in height in combination with marked weight gain. It can also interfere with metabolism and cause high blood sugar levels.

What causes Cushing syndrome?

Cushing syndrome can be caused by endogenous (internal) and/or exogenous (external) factors.

Endogenous

• Tumor of the adrenal gland
• Too much adrenocorticotropic hormone (ACTH), a hormone made by the pituitary gland, that stimulates the adrenal glands to make cortisol
• Other tumors that make too much ACTH
• High levels of other hormones that increase ACTH production (such as CRH)

Exogenous

• Long-term use of moderate to high doses of medications called glucocorticoids. Glucocorticoids include hydrocortisone, prednisone, prednisolone, dexamethasone and other similar medications. These medications are used to reduce inflammation in conditions such as asthma, arthritis, inflammatory bowel disorders and connective tissue disorders. While taking these medications by mouth is the most common cause of Cushing syndrome, this condition also occurs with prolonged and heavy exposure to glucocorticoids applied on the skin or inhaled. Thus, it is very important to follow the directions of a health care professional to avoid overuse of such medications.

What are the symptoms of Cushing syndrome?

The most common symptom in children with Cushing syndrome is weight gain without an appropriate increase in height. This is the most common symptom of Cushing syndrome in children who are still growing.

Symptoms may vary among patients with Cushing syndrome. Here are the most common symptoms and signs:

• Weight gain, particularly around the abdomen (belly area)
• Slow or no change in height (this is not useful if your child has completed growth.)
• Round and red appearance of the face (sometimes called "moon face")
• Fat deposition in the neck and upper back
• Thin arms and legs
• Muscle weakness
• Purple or red stretch marks

Rev. 6/2020. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.