Case Study of Cushing Syndrome: Sara Haines at CDU - Treatment Options

This case study focuses on Sara Haines, a 38-year-old woman presenting with symptoms indicative of Cushing syndrome, including weight gain, facial hair growth, menstrual abnormalities, and increased thirst and appetite. The study identifies the primary signs and symptoms of Cushing syndrome, such as fatty tissue accumulation, acne, hypertension, bone loss, and stretch marks. In women, irregular menstrual cycles and increased hair growth are noted, while men may experience erectile dysfunction and decreased fertility. The study further explores treatment options for Sara, including reducing corticosteroid usage, surgery to remove tumors, radiation therapy, and medications like metopirone, lysodren, and nizoral to control cortisol production. The document concludes with a list of references supporting the analysis and treatment recommendations. Desklib provides access to similar case studies and resources for students.

Running head: CASE STUDY ON CUSHING SYNDROME
1
Case Study on Cushing Syndrome
Name of the Student
Name of the Instructor
Course Code
Date

CASE STUDY ON CUSHING SYNDROME 2
1. Describe the primary signs and symptoms of Cushing syndrome.
Answer 1: In the research, it has been found that Cushing syndrome generally happens when the
body of an individual gets exposed to huge amount of hormone cortisol for a longer period of
time (Lowe, Young Jr, Lyssikatos, Stratakis & Carney, 2017). Cushing syndrome is also known
to be hypercortisolism and which mostly happens because of the utilization of oral corticosteroid
pills. Cushing syndrome can be seen when the body of any person develops plenty of cortisol
independently. The symptoms and signs of Cushing syndrome vary from person to person based
on the levels of cortisol. The most common form of symptoms and signs of Cushing syndrome
are changed in skin structure followed by progressive obesity. The other kinds of signs related to
Cushing syndrome are as follows:
1. Accumulation of fatty tissues followed by weight gain in the face, between the two
shoulders, around upper back and midsection of the body.
2. Formation of acne.
3. Irritability, hypertension, anxiety, and depression (Nieman, 2015).
4. Loss of bones which further results in major fractures.
5. Formation of purple or pink stretch marks over the skin of arms, thighs, abdomen, and
breasts.
6. Slow curing of infections, insect bites, and cuts.
The most common symptoms of Cushing syndrome that are found in women are as follows:
1. Absence or irregular menstrual cycle.
2. The visibility of the facial and body hair gets increased and the hairs also become
thicker (Nieman, Biller, Findling, Murad, Newell-Price, Savage & Tabarin, 2015).

CASE STUDY ON CUSHING SYNDROME 3
The most common symptoms of Cushing syndrome that are found in men are as follows:
1. It males there can be erectile dysfunction (Ceccato, Barbot, Zilio, Frigo, Albiger,
Camozzi, & Scaroni, 2015).
2. The decrease in the fertility.
3. The decrease in libido.
2. What treatment and follow up options are there for her condition?
Answer 2: Sara Hainesis had been suffering from Cushing syndrome and there are various kinds
of treatments available that can be used for enhancing her health condition. The treatment-related
to Cushing syndrome is specially prepared to reduce her increased level of cortisol within her
body (Poidvin, Storey-London, Martinerie, Léger, Braun, Lahlou & Carel, 2016). The lists of
treatments that can be given to her are as follows:
1. Reducing the usage of corticosteroid: If the Cushing syndrome for Sara had occurred
due to long-term use of corticosteroid pills, then her doctor can reduce the excessive
dosage of that particular drug for controlling the disease. This method can also be used
for managing her asthma.
2. Surgery: If the Cushing syndrome results in forming a tumor on the body of Sara, then
the doctor may instruct her for the surgical removal of that tumor (Daniel, Aylwin,
Mustafa, Ball, Munir, Boelaert & Davis, 2015).
3. Radiation therapy: It can be seen that if the surgeon is unable to remove the tumor on
Sara, then the surgeon may recommend for radiation therapy with the help of a technique
known to be stereotactic radiosurgery (Nieman, 2018).

CASE STUDY ON CUSHING SYNDROME 4
4. Medications: After the thorough research it has been found that medications can be
utilized for controlling the cortisol production of Sara when the radiation therapy and
surgery get failed. It has been found that medications can be utilized much before any
kind of surgery on her if she feels sicker due to Cushing syndrome (Nieman, Biller,
Findling, Murad, Newell-Price, Savage & Tabarin, 2015). Most of the doctors usually
instruct to use drug therapy before doing any kind of surgery for improving the symptoms
thereby minimizing the risks related to surgery. The types of medications that are
recommended for Sara includes metopirone, lysodren, and nizoral.

CASE STUDY ON CUSHING SYNDROME 5
References
Ceccato, F., Barbot, M., Zilio, M., Frigo, A. C., Albiger, N., Camozzi, V., ... & Scaroni, C.
(2015). Screening tests for Cushing's syndrome: urinary free cortisol role measured by
LC-MS/MS. The Journal of Clinical Endocrinology & Metabolism, 100(10), 3856-3861.
Daniel, E., Aylwin, S., Mustafa, O., Ball, S., Munir, A., Boelaert, K., ... & Davis, J. (2015). The
effectiveness of metyrapone in treating Cushing's syndrome: a retrospective multicenter
study in 195 patients. The Journal of Clinical Endocrinology & Metabolism, 100(11),
4146-4154.
Lowe, K. M., Young Jr, W. F., Lyssikatos, C., Stratakis, C. A., & Carney, J. A. (2017). Cushing
Syndrome in Carney Complex: Clinical, Pathological, and Molecular Genetic Findings in
the 17 Affected Mayo Clinic Patients. The American journal of surgical pathology, 41(2),
171.
Nieman, L. K. (2015). Cushing's syndrome: update on signs, symptoms and biochemical
screening. European journal of endocrinology, 173(4), M33-M38.
Nieman, L. K. (2018). Recent Updates on the Diagnosis and Management of Cushing's
Syndrome. Endocrinology and Metabolism, 33(2), 139-146.
Nieman, L. K., Biller, B. M., Findling, J. W., Murad, M. H., Newell-Price, J., Savage, M. O., &
Tabarin, A. (2015). Treatment of Cushing's syndrome: an endocrine society clinical
practice guideline. The Journal of Clinical Endocrinology & Metabolism, 100(8), 2807-
2831.

CASE STUDY ON CUSHING SYNDROME 6
Nieman, L. K., Biller, B. M., Findling, J. W., Murad, M. H., Newell-Price, J., Savage, M. O., &
Tabarin, A. (2015). Treatment of Cushing's syndrome: an endocrine society clinical
practice guideline. The Journal of Clinical Endocrinology & Metabolism, 100(8), 2807-
2831.
Poidvin, A., Storey-London, C., Martinerie, L., Léger, J., Braun, K., Lahlou, N., & Carel, J. C.
(2016). Successful medical management of severe neonatal Cushing syndrome with
metyrapone, guided by mass spectrometry monitoring. Delta, 30, 40.