Cushing Syndrome Case Study: St Vincent's Hospital, Toowoomba

This case study examines Sara Haines, a 38-year-old business owner, who presented with symptoms indicative of Cushing syndrome, including weight gain, facial hair growth, menstrual irregularities, and psychological distress. The assignment addresses the causes and mechanisms of Cushing syndrome, which is characterized by prolonged exposure to high levels of cortisol, often resulting from overproduction of ACTH or adrenal gland dysfunction. The case study also outlines the common signs and symptoms of Cushing syndrome, such as weight gain, skin changes, muscle weakness, and psychological issues. The study highlights various treatment options, including reducing corticosteroid use, surgery, and radiation therapy, depending on the underlying cause. The provided case study provides a comprehensive overview of the condition, its diagnosis, and management strategies.

Running head: SARA HAINES CUSHING SYNDROME CASE STUDY
Sara Haines Cushing syndrome case study
Name of the student
Name of the university
Authors note

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SARA HAINES CUSHING SYNDROME CASE STUDY
Response to question number 1:
Cushing syndrome develops when the human body exposed to huge levels of the
hormone cortisol for an elongated period. Hypercortisolism is another name of Cushing
syndrome. This can arise when the human body makes the excessive amount of cortisol. Adrenal
glands produce the cortisol hormone, which controls the blood pressure and helps the
cardiovascular system works correctly. This excessive amounts of cortisol hormone are
responsible for Cushing syndrome (Nieman2015). Cushing syndrome occurs due to the
overproduction of adrenocorticotropic hormone or ACTH by one or both adrenal glands, which
generally controls the cortisol production. This ACTH excites the adrenal gland which also
releases cortisol and additional steroid hormones (Lacroixet al., 2015).
ACTH discharged in a diurnal pattern that is free of flowing levels of cortisol, crest
discharge happens before just arousing, and the ACTH levels at that point decrease for the entire
day (Carney et al., 2015). Even though the adenomas of Cushing’s infection emit extreme
measures of ACTH, they usually keep several adverse criticism reactions to huge doses of
glucocorticoids. Exotic sources of ACTH, generally inside the appearance of extracranial
neoplasms, are usually not reactive to negative feedback with huge doses of glucocorticoids
(Niemanet al., 2015). This separation is suitable for constructing the development of patients,
with so-called hypercortisolism.
Sara can develop her condition with the help of treatment. There are several treatments,
like reduce the use of corticosteroid, under doctors’ supervision. Surgery is another technique
which applied in case of a tumour, like a pituitary tumour, which is operated by the

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SARA HAINES CUSHING SYNDROME CASE STUDY
neurosurgeon. In case, if the doctors became unsuccessful in removing the cyst, then they apply
the radiation technique, for further treatment.
Response to question number 2:
According to Iacobone et al., (2015) symptoms and signs of Cushing syndrome depend
on the concentrations of the higher amount of cortisol. There are some general symptoms and
signs, results in growing obesity and also develops skin changes like:
 Increasing body weight and deposits of fats within the tissue, mainly in the middle region
and back mostly in the upper portion, face and shoulder.
 “Moon Face” - an adjusted state of the face that creates from a particular example of fat
dissemination (Prague, May & Whitelaw, 2013).
 There are some pink and purple elongated marks on the epidermis of the stomach, breast,
thighs, and several regions of an arm.
 Easy bruising – the legs and arms are often covered with several bruises.
 Weaken, easily broken skin that bruises simply
 Slow development of wounds, infection due to bites of an insect.
 Spots on facial skin.
 “Buffalo hump” - a hill of fat at the base of the back of the neck.
 In the case of women, facial hair starts growing on their face.
 It also affects the menstrual cycle and results in irregular or absent condition.
There are several other signs and symptoms are present like:
 Simple weakness.

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SARA HAINES CUSHING SYNDROME CASE STUDY
 The weakness of body muscle.
 Sadness, concern, and irritability.
 Damage to sensitive control.
 Mental problems.
 High blood pressure.
 Headache.
 Loss of bone density, significant to breakages over time
 In offspring, diminished growth.
When this signs and symptoms have arrived, individuals need to concern with their
respective doctor for further treatment.

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SARA HAINES CUSHING SYNDROME CASE STUDY
References:
Carney, J. A., Lyssikatos, C., Lodish, M. B., & Stratakis, C. A. (2015). Germline PRKACA
amplification leads to Cushing syndrome caused by 3 adrenocortical pathologic phenotypes.
Human pathology, 46(1), 40-49.
Iacobone, M., Citton, M., Scarpa, M., Viel, G., Boscaro, M., & Nitti, D. (2015). Systematic
review of surgical treatment of subclinical Cushing's syndrome. British Journal of Surgery,
102(4), 318-330.
Lacroix, A., Feelders, R. A., Stratakis, C. A., & Nieman, L. K. (2015). Cushing's syndrome. The
lancet, 386(9996), 913-927.
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., 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.
Prague, J. K., May, S., & Whitelaw, B. C. (2013). Cushing’s syndrome. Bmj, 346, f945.