Cushing Syndrome Analysis: Symptoms, Risk Factors, Graves' Disease

This report provides a comprehensive overview of Cushing's syndrome, detailing its signs and symptoms, which include a round face, stretch marks, fat accumulation, and menstrual irregularities in women, along with decreased libido and erectile dysfunction in men. The report also discusses the increased risk of hypertension in patients like Sara, highlighting the roles of obesity, lack of exercise, betamethasone use, and depression. It differentiates between Graves' disease, an autoimmune disorder causing thyroid hormone overproduction, and Cushing's syndrome, which is characterized by excess cortisol. The report references several studies and provides a clear understanding of the condition's complexities, causes, and related health risks, with a focus on the impact of clinical history on patient outcomes and the importance of differentiating between similar conditions.

Running head: BODY INTEGRITY 1
Body Integrity
Student’s Name
Institutional Affiliation

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Describe the primary signs and symptoms of Cushing syndrome.
Cushing syndrome is a type of disorder which is due to prolonged subjection of body tissues
to excess cortisol. The endogenous causes of Cushing’s syndrome include ACTH-dependent and
ACTH-independent. Some of the ACTH-dependent causes incorporate of ectopic ACTH-
producing tumors and the Cushing’s disease. On the other hand, ACTH-independent causes
include a rare micro nodular adrenal hyperplasia and cortisol-producing adrenal benign.
However, its common cause is the consumption of excess glucocorticosteroid medicine which
may be comprised of different types such as prednisolone, prednisone and dexamethasone.
Cushing’s syndrome affects more females than males at a ratio of 3 to 1 and majorly occurs
between the ages of 20 years to 60 years.
Signs and symptoms of Cushing’s syndrome vary and individuals who have very high levels
of cortisol for a prolonged period of time will have clear signs like having a round face, broad
purple stretch marks especially on the hips, under the arms, breasts and abdomen, large amounts
of fat around their neck base and a fatty hump between the shoulders (Nieman, 2015).
Consequently, menstruation in women may stop or occur uneven and they may develop excess
hair on their abdomen, face, chest, thighs and neck. Also, they develop a moon face from a
particular arrangement of fat dispersion (Nieman, 2015). Men develop fertility complications and
their interest to sex is decreased and they may have erectile dysfunction. Another sign of this
disorder is the thinning of skin. In that case, the skin develops a shiny, paper-thin condition and it
might tear easily (Nieman, 2015).
Hypertension, weight gain along with easy bruising especially at the abdomen is also signs
and symptoms of Cushing’s syndrome (Nieman, 2015). Furthermore, several patients with the

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disorder feel very high due to mood change and others experience sudden emotional ups and
downs as they become quick to anger.
What aspects of her clinical history place Sara at increased risk of hypertension
and, briefly explain the difference between Graves’ disease and Cushing syndrome
Obesity contributes much to the development of hypertension through the interaction of
epigenetic, dietary and environmental factors. The extreme weight gain that Sara experienced
over the six months places her at an increased risk of blood pressure since the more weight the
more blood flow is required to supply nutrients and blood to body tissues. In that case, when the
blood volume circulating through the vessels increases, then the pressure inside the arteries also
increase (Lavie, Milani & Ventura, 2009).. Also, physical exercise increases the flow of blood
through the body arteries resulting to the release of cytokines and natural hormones that makes
the blood vessels to relax hence lowering the blood pressure (Booth, Roberts & Laye, 2012).
However, since Sara stopped doing the exercises that she was usually doing at Action Indoor
Sports Stadium she is at a higher risk of an increased high blood pressure.
Furthermore, the clinical history of Sara shows that she has been using betamethasone for
many years to treat asthma which is a chronic condition and it increases the risk of high blood
pressure (Norman, 2017). Asthma has been linked to cardiovascular disease and related to risks
of getting hypertension. Also, depression puts the body on a constant alert that places a strain on
several body organs. The feeling of depression that Sara experiences might be due to some
stressful events which results to a temporary but dramatic rise in blood pressure (Meng, Chen,
Yang, Zheng, & Hui, 2012).
Graves’ disease is a disorder of the immune system that results in the overproduction of
thyroid hormones (Weetman, 2010) while Cushing syndrome is a state that is caused by presence

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of excessive hormone known as cortisol in the body (Raff & Carroll, 2015). When somebody is
affected by the Graves’ disease one of the signs and symptoms noticed is weight loss but in the
case of Cushing syndrome weight gain is a symptom of the condition (Sonino, Fava, Belluardo,
Girelli & Boscaro, 2013).

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References
Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic
diseases. Comprehensive Physiology, 2(2), 1143.
Lavie, C. J., Milani, R. V., & Ventura, H. O. (2009). Obesity and cardiovascular disease: risk
factor, paradox, and impact of weight loss. Journal of the American College of
Cardiology, 53(21), 1925-1932.
Meng, L., Chen, D., Yang, Y., Zheng, Y., & Hui, R. (2012). Depression increases the risk of
hypertension incidence: a meta-analysis of prospective cohort studies. Journal of
hypertension, 30(5), 842-851.
Nieman, L. K. (2015). Cushing's syndrome: update on signs, symptoms and biochemical
screening. European journal of endocrinology, 173(4), M33-M38.
Norman, M. (2017). Repeat doses of antenatal betamethasone and risk factors for
cardiometabolic disease at early school age. Acta Paediatrica, 106(5), 846-846.
Raff, H., & Carroll, T. (2015). Cushing's syndrome: from physiological principles to diagnosis
and clinical care. The Journal of physiology, 593(3), 493-506.
Sonino, N., Fava, G. A., Belluardo, P., Girelli, M. E., & Boscaro, M. (2013). Course of
depression in Cushing’s syndrome: response to treatment and comparison with Graves’
disease. Hormone Research in Paediatrics, 39(5-6), 202-206.
Weetman, A. P. (2010). Graves' disease. New England Journal of Medicine, 343(17), 1236-1248.