Which assessment finding indicates hypersecretion of adrenocorticotropic hormone
DiagnosisTaking glucocorticoid medications is the most common cause of Cushing syndrome. Your doctor can review all your medications — pills, injections, creams and inhalers — to determine if you're taking medications that can cause the disorder. If you are, you probably won't need other tests. Show
Cushing syndrome from endogenous cortisol production can be difficult to diagnose because other conditions have similar signs and symptoms. Diagnosing Cushing syndrome can be a long and extensive process. You'll likely need to see a doctor who specializes in hormonal disorders (endocrinologist). Your doctor will conduct a physical exam and look for indications of Cushing syndrome, such as rounding of the face, a pad of fatty tissue between the shoulders and neck, and thin skin with bruises and stretch marks. If you haven't been using a corticosteroid medication, these diagnostic tests may help pinpoint the cause:
These tests help your doctor diagnose Cushing syndrome, and they may help rule out other medical conditions, such as polycystic ovary syndrome — a hormone disorder in women with enlarged ovaries. Depression, eating disorders and alcoholism also can partially mimic Cushing syndrome. TreatmentTreatments for Cushing syndrome are designed to lower the high level of cortisol in your body. The best treatment for you depends on the cause of the syndrome. Options include: Reducing corticosteroid useIf the cause of Cushing syndrome is long-term use of corticosteroid medications, your doctor may be able to keep your Cushing syndrome signs and symptoms under control by reducing the dosage of the drug over a period of time, while still managing the condition for which you take it. Don't reduce the dose of corticosteroid drugs or stop taking them on your own. Do so only under your doctor's supervision. Abruptly discontinuing these medications could lead to deficient cortisol levels. Slowly tapering off corticosteroid drugs allows your body to resume normal cortisol production. SurgeryIf the cause of Cushing syndrome is a tumor, your doctor may recommend complete surgical removal. Pituitary tumors are typically removed by a neurosurgeon, who may perform the procedure through your nose. For a tumor in the adrenal glands, lungs or pancreas, the surgeon can remove it through a standard operation or by using minimally invasive surgical techniques, with smaller incisions. After the operation, you'll need to take cortisol replacement medications to provide your body with the correct amount of cortisol. In most cases, you'll eventually return to normal adrenal hormone production, and your doctor can taper off the replacement drugs. Your endocrinologist will use blood tests to help determine if you need cortisol replacement and when it may be stopped. However, this process can take up to a year or longer. In some instances, people with Cushing syndrome never return to normal adrenal function. They then need lifelong replacement therapy. Radiation therapyIf the surgeon can't totally remove a pituitary tumor, he or she will usually prescribe radiation therapy as well as surgery. Additionally, radiation may be used for people who aren't suitable candidates for surgery. Radiation can be given in small doses over a six-week period, or with a technique called stereotactic radiosurgery. In the latter procedure, a large, one-time dose of radiation is delivered to the tumor, and the radiation exposure to surrounding tissues is minimized. MedicationsMedications can be used to control cortisol production when surgery and radiation don't work. Medications might also be used before surgery in people who have become very sick with Cushing syndrome to improve signs and symptoms and minimize surgical risk. Medical therapy may not completely improve all of the symptoms of excess cortisol. Medications to control excessive production of cortisol at the adrenal gland include ketoconazole, mitotane (Lysodren) and metyrapone (Metopirone). Mifepristone (Korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance. Mifepristone does not decrease cortisol production, but it blocks the effect of cortisol on your tissues. Side effects from these medications may include fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium and swelling. Some have more-serious side effects, such as neurological side effects and liver toxicity. Newer medications for Cushing syndrome include pasireotide (Signifor), given as a twice-daily injection, and osilodrostat (Isturisa), a pill. Other medications are being developed. In some cases, the tumor or its treatment will cause the pituitary or adrenal gland to produce not enough of other hormones, and your doctor will recommend hormone replacement medications. If none of these treatment options is appropriate or effective, your doctor may recommend surgical removal of your adrenal glands (bilateral adrenalectomy). This procedure will cure excess production of cortisol but will require lifelong replacement medications. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus
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that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Clinical trialsExplore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Lifestyle and home remediesThe length of your recovery from Cushing syndrome will depend on the severity and cause of your condition. You didn't develop Cushing syndrome overnight, and your symptoms won't disappear overnight, either. In the meantime, these tips may help you on your journey back to health.
Coping and supportSupport groups can be valuable in dealing with Cushing syndrome and recovery. They bring you together with other people who are coping with the same kinds of challenges, along with their families and friends, and offer a setting in which you can share common problems. Ask your doctor about support groups in your community. Your local health department, public library and telephone book as well as the internet also may be good sources to find a support group in your area. Preparing for your appointmentYou're likely to first see your primary care doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to a doctor who specializes in hormonal disorders (endocrinologist). It's a good idea to prepare for your appointment so that you can make the most of your time with your doctor. Here's some information to help you get ready, and what to expect from your doctor. What you can do
Your time with your doctor may be limited, so preparing a list of questions ahead of time may help you make the most of your time together. For Cushing syndrome, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask any additional questions during your appointment. What to expect from your doctorYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
Which clinical feature is indicative of hypercortisolism?The most common clinical symptom is progressive weight gain, which is typically but not invariably centrally dominant. The weight gain in patients with HCM can, however also be generalized and akin to nonsyndromic obesity.
Which clinical manifestation is found in a client with deficiency of adrenocorticotropic hormone?Isolated ACTH deficiency primarily presents with symptoms of adrenal insufficiency due to lack of ACTH secretion, along with general fatigue, loss of appetite, nausea, vomiting and skin dryness.
Which clinical manifestation is observed in a client with adrenal insufficiency?Main features — The predominant manifestation of adrenal crisis is shock, but the patients often have nonspecific symptoms such as anorexia, nausea, vomiting, abdominal pain, weakness, fatigue, lethargy, fever, confusion, or coma (table 1).
Which signs would the nurse expect a client to exhibit with Cushing syndrome?Signs and Symptoms Associated with Cushing's Syndrome/Disease: Weight gain in face (moon face) Weight gain above the collar bone (supraclavicular fat pad) Weight gain on the back of neck (buffalo hump)
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