Exogenous Cushing’s Syndrome

Exogenous Cushing’s Syndrome 1
EXOGENOUS CUSHING’S SYNDROME
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Exogenous Cushing’s Syndrome 2
Question 1
Exogenous Cushing’s syndrome is a condition caused by elevated levels of cortisol that
results from excessive intake of glucocorticoids. Cushing’s syndrome is an endrocrinopathy as it
results from inability of an endocrine gland to function properly. Cushing syndrome can be as a
result of a primary cause and a secondary cause. The primary cause is independent of the ACTH
hormone produced by the pituitary gland. The primary causes are related to over secretion of
cortisol by the adrenal gland and include adrenal tumors (Sharma, Nieman & Feelders, 2015).
On the other hand secondary causes of Cushing’s syndrome are ACTH dependent. The pituitary
gland is also referred to as the master gland as it controls other glands within the body of which
the adrenal gland is part of them.
ACTH is secreted by the pituitary gland and has its effect on the adrenal gland where it
stimulates the release of cortisol. Increased secretion of ACTH can therefore cause abnormal
secretion of cortisol by the adrenal gland hence Cushing’s syndrome. Exogenous Cushing’s
syndrome results from excessive glucocorticoid hormone intake is ACTH independent (Morgan,
Hassan-Smith & Lavery, 2016). As the term explains, an exogenous cause of a disease is any
cause that comes from outside the body. Ms. Maureen’s case of exogenous Cushing’s syndrome
was as a result of a high dose of corticosteroid medication that was prescribed for her rheumatoid
arthritis. Prednisolone is a corticosteroid that is used to treat various medical conditions.
The incidence of Exogenous Cushing’s syndrome varies depending on the population
beliefs and perception as far as corticosteroids are concerned. Patients suffering from medical
conditions that are associated with corticosteroid intake such as rheumatoid arthritis and other
inflammatory diseases like asthma, lupus urticaria and inflammatory bowel disease tend to suffer
from the condition as compared to those who are don’t take such medications. According to

Exogenous Cushing’s Syndrome 3
Pivonello et al. (2016), frequency of the condition varies from one population to another
depending on cultural and ethnic backgrounds. For example, there are a number of communities
that don’t believe in taking corticosteroids due to their negative belief systems associated with
such medication. The condition is associated with excessive intake of corticosteroids and this can
be caused by exacerbation of conditions that require these types of medication. Ms. Maureen for
example sought high doses of the corticosteroid prednisolone due to exacerbation of her
rheumatic arthritis condition hence was predisposed to contracting the disease.
There are a number of risk factors associated with exogenous Cushing’s syndrome. The
main risk factor is obviously excessive intake of glucocorticoids due to a current inflammatory
medical condition. The medications of corticosteroids can either be oral doses or injectable
medicines. As stated by Pappachan et al. (2017), the risk of contracting the condition is increased
by overuse of these medications. Corticosteroids cause immune suppression. Such a disease has
a lot of impact on the patient and the family as well. The patient may undergo a lot of depression
and lose of hope in life. Because of the severity of the disease, the patient may lose their job and
this can negatively affect the family dependent on the patient as income to support and provide
for family members would no longer be there.
Question 2
There are various signs and symptoms associated with exogenous Cushing’s syndrome. A
common sign associated with the disease is weight gain and deposition of fatty tissue around the
belly and formation of a buffalo hump between the shoulders. The patient as is the case of
Sharon presents with a moon face that is the face becomes rounder. In addition to these, it can
exacerbate obesity in individuals with the condition as there is increased fat deposition in these
tissues. The pathophysiology behind these fat related signs and symptoms is the fact that