Cushing Syndrome In Babies and Toddler

Cushing’s syndrome is a rare hormonal condition in which the level of cortisol hormone in the body is much higher than usual. Cushing’s syndrome is also called hypercortisolism. Cortisol is also called the stress hormone.

It can also occur in children sometimes, and it’s called Hypercortisolism.

Sometimes called hyper cortisol’s, Cushing’s syndrome is relatively rare and most commonly affects adults aged 20 to 50. 

Cushing’s Syndrome
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Table of Contents

Cushing syndrome glucose levels

GC balance is connected with increased glucose production due to the stimulation of gluconeogenesis and the development of insulin resistance, mainly in the liver and in the skeletal muscle, which reduces glycogen synthesis and glucose uptake.

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Causes and risk factors

  • Excessive production of cortisol.
  • Medications like too much taking of corticosteroid, this treatment is the most common cause of Cushing’s syndrome.
  • The pituitary tumor that produces ACTH also called Cushing’s disease. 
  • Primary overproductions of cortisol by the adrenal gland due to adrenal hyperplasia, malignant tumors of the adrenal gland are rare.
  • Enlargement of both adrenal glands.
  • Certain kinds of cancer.
  • An inherited endocrine disorder.

Signs and symptoms

  • Weight gain, mainly in the neck, face, trunk
  • Changes in skin, including purple stretch marks and other signs of skin thinning.
  • Proximal muscle weakness raising arms, difficulty in climbing stairs, getting out of a low chair.
  • Psychological issues such as depression, cognitive dysfunction, and emotional lability.
  • New onset or of high blood pressure and diabetes mellitus.
  • Polyuria or polydipsia.
  • Reduce bone mass and fractures caused by weakened bones.
  • Impaired wound healing and predisposition to infection because of impaired immune function.
  • Irregular menses, amenorrhea.

Diagnostic evaluation

  • Corticotrophin releasing hormone (CRH) Stimulation test
  • Chest and abdominal CT scans
  • CT scan and MRI of the brain 
  • 24-hour urinary free cortisol level
  • Overnight 1 mg dexamethasone suppression test
  •  48-hour low dose dexamethasone suppression test

Treatment

  • The goal of treating Cushing’s syndrome is to remove, block or minimize the body’s exposure to excess cortisol
  • It may depend upon the excess level of cortisol include radiation, surgery, chemotherapy.
  • Cushing syndrome caused by a pituitary tumor that releases ACTH
  • If the patient cannot stop taking the medication because of disease, high blood pressure, high blood sugar, high cholesterol levels, osteoporosis, bone thinning, they should be monitored carefully. 
  • Surgery to remove the tumor
  • Chemotherapy
  • Radiation after removal of a pituitary tumor
  • The patient may need hydrocortisone replacement therapy after surgery and possibly continued throughout life 
  • Surgery to remove the tumor
  • If cancer cannot be removed, medications to help block the release of cortisol
  • Drugs that inhibit the synthesis of corticosteroid
  • Persons receiving the medications may require corticosteroid replacement to avoid adrenal insufficiency. 

Which treatment do you use from above list to treat your child? Let me know in the comments below.

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