Adrenal gland - Disorders of cortisol secretion - Cushing's disease

6 important questions on Adrenal gland - Disorders of cortisol secretion - Cushing's disease

What is Cushing's disease?

It is condition characterized by cortisol excess

What are the causes of cushing's disease?

1. Administration of exogenous glucocorticoids (iatrogenic)
2. ACTH oversecreting pituitary tumor (secondary hyperadrenocorticism) - 80%
3. Adrenal disease (tumor) - 10-15%

How do we diagnose cushing's disease?

1. ACTH stim test
2. Dexamethasone suppression test
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What are the clinical signs of cushing's disease?

PU/PD, muscle atrophy, increased fat deposits, impaired wound healing, co-morbid diabetes mellitus, hyperpigmentation from POMC being broken down into ACTH and MSH

How do we treat cushing's disease?

Dogs: mitotane and trilostane: inhibit conversion of precursor molecules to steroid hormones
Horses: pergolide: D2 receptor reduces POMC production in pars intermedia

What is PPID (pituitary pars intermedia dysfunction)?

It is a disease that occurs in 20% of horses over 15 years, ACTH oversecretion occurs in a result of a tumor in pars intermedia. Dopamine is decreased.

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