Itsenko-Cushing disease is an endocrine pathology, the basis of which is the development of a malfunction of the hypothalamic-pituitary system, leading to an increased production of adrenocorticotropic hormone (ACTH). By increasing the level of ACTH in the body, a secondary hyperfunction of the adrenal cortex is formed. All this leads to inhibition of metabolic processes, as well as changes from virtually all body systems.
The prevalence of Itsenko-Cushing’s disease is not so high. According to statistics, this disease is diagnosed in about five people per million population. At the same time, women face this disorder several times more often than men. Most often, the development of such pathology are those aged twenty-five to forty years.
Itsenko-Cushing disease is very important to distinguish from Itsenko-Kushin syndrome. These conditions are accompanied by almost the same clinical picture, but the mechanism of their development, and accordingly, the principles of treatment are significantly different. In Itsenko-Cushing’s syndrome level hormones increases mainly due to tumors localized in the adrenal cortex. However, such changes can also develop with long-term use of glucocorticosteroids. As for the disease that we are considering in this article, the hypothalamic-pituitary system is affected first, and only then the adrenal glands are involved in the pathological process.
In the overwhelming majority of cases, tumor formation in the pituitary gland contributes to the formation of Itsenko-Cushing disease. Some variants of such tumors are characterized by hormone-secreting activity. Sometimes the development of this pathology is preceded by transferred traumatic brain injuries, inflammatory processes in the central nervous system, as well as severe intoxication. As for women, they can have this condition on the background of pregnancy, menopause, and so on.
As we have said, primary in the body increases the synthesis of ACTH. It is through ACTH that hormones such as glucocorticoids and androgens begin to be actively generated. The level of mineralocorticoids increases to a somewhat lesser extent. All these changes contribute to the acceleration of the breakdown of proteins and carbohydrates, which leads to an increase in atrophic changes in the connective and muscle fibers. In addition, the body’s glucose level rises, fat metabolism is inhibited, and calcium is washed out of bone tissue.
The classification of Itsenko-Cushing’s disease includes three of its severity: mild, moderate and severe. With a mild degree, the clinical picture is very mild and may not even deliver significant discomfort to a sick person. The average degree is accompanied by more intense manifestations, but any complications do not develop. Severe implies a variety of complications.
In addition, this disease can be torpid and progressive. With a progressive version of the symptoms are growing quite rapidly. As a rule, the development of a full-fledged clinical picture takes no more than one year. In the case of the torpid variant, pathological changes in the body are formed slowly. On their appearance can take from three to ten years.
Symptoms of Itsenko-Cushing disease
With this pathology, almost all internal systems of the body are affected. First of all, a sick person acquires a rather specific appearance due to excess fat deposits on the face, neck, back and abdomen. Despite the fact that the abdomen and chest increase in volume, the limbs remain thin. The appearance of excessive dryness of the skin is noted, they show a purple-marbled pattern and stretch marks. Quite often the patient suffers from acne.
There are mandatory symptoms indicating endocrine disorders. These include changes in the menstrual cycle in women, increased hair growth on the body and face, or hair loss on the head, as well as inhibition of potency in men. A sick person begins to complain of recurring pain in the bones, their frequent fractures. In that case, if the child is faced with such a disease, then he may experience stunted growth. There are various cardiovascular disorders, for example, a systematic increase in blood pressure, chronic heart failure, and so on.
A patient with this diagnosis suffers from a variety of gastrointestinal problems. He often has pains in the area of epigastria, heartburn, ulcers in the stomach and duodenum, gastrointestinal bleeding and much more. As a rule, the clinical picture is complemented by symptoms that indicate the occurrence of neurological disorders.
Consequences when changing hormone levels
The prognosis for this disease directly depends on its duration and severity. In that case, if you do not treat the Itsenko-Cushing disease, there is a high probability of forming irreversible changes in the bone, cardiovascular and other systems.
Diagnosis and treatment of the disease
To diagnose this pathological process, biochemical blood test, the results of which will determine a number of specific deviations. Hormones, namely the level of glucocorticoid and adrenocorticotropic, are necessarily evaluated. Additionally, radiography or computed tomography of the brain, as well as an ultrasound examination of the adrenal glands can be performed.
Treatment diseases Itsenko-Cushing is carried out with the help of drugs, radiation therapy, as well as through surgical intervention. It all depends on the case. Of the drugs used are those drugs that block the functional activity of the pituitary gland and the production of ACTH.
The principles of prevention are reduced to the avoidance of traumatic brain injuries, intoxication of the body, as well as to the timely treatment of infectious pathologies from the central nervous system.