Cushing’s Disease

Treatment of Cushing’s Disease in Orange County

Treatment of Cushing’s Disease in Orange CountyCushing’s disease is a serious hormonal disorder caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH), resulting in overproduction of steroid hormone cortisol in the blood level. ACTH stimulates the adrenal glands that is located on top of the kidneys to produce cortisol, commonly known as the stress hormone.

 

 

Cushing’s disease is caused by a pituitary tumor or your body’s own overproduction of cortisol by the adrenal glads, located on the base of the brain. This may occur from excess production by one or both adrenal glands, or overproduction of the adrenocorticotropic hormone (ACTH) that regulates cortisol production.

Patients with Cushing’s disease have too much ACTH, which stimulates the production and release of cortisol, also called stress hormone because it is released during stressful situations. Cortisol controls the body’s use of carbohydrates, proteins, fats, and also helps reduce the immune system’s response to swelling.

Some physical symptoms of Cushing’s disease are easier to notice than others. Robert Louis, MD will look for specific physical signs of Cushing’s Disease and may do some tests to better understand your symptoms.

  • Headache
  • Backache
  • Lethargy or fatigue
  • Mental change (depression or anxiety)
  • Irritable
  • Change in appetite
  • A round and/or red face
  • Acne or skin infections
  • Purplish streaks across the skin
  • Unusual buildup of fatty tissue between the shoulder blades
  • Unusual buildup of fatty tissue in the abdominal area with thin arms and legs
  • Excess facial/body hair growth in women
  • Sleeping problem
  • Increased thirst or urination
  • Impotence

After you are diagnosed with Cushing’s disease, it is important that your doctor continues the diagnostic process to determine the cause. When you present with signs and symptoms, various tests will follow to establish the presence of pituitary tumor.

  • Hormone testing
  • 24-hour urine free cortisol (UFC) measurement
  • Cortisol saliva testing
  • Magnetic resonance imaging (MRI)
  • Inferior petrosal sinus sampling (IPSS)

Hormone testing: Dr. Louis will order urine free cortisol (UFC) measurement. If Cushing’s disease is present, the 24-hour UFC levels are typically at least four to five times greater than normal.

Cortisol saliva testing: Additional testing for the level of cortisol in the saliva may be required. The amount of cortisol in the saliva around midnight is normally very low. Elevated salivary cortisol levels around midnight may help confirm the diagnosis of Cushing’s disease.

Magnetic resonance imaging (MRI): An MRI scan of the pituitary gland is the best way to detect the presence of an adenoma in Cushing’s disease.

Inferior petrosal sinus sampling In case MRI fails to identify Cushing’s disease, additional test using inferior petrosal sinus sampling (IPSS) may be required.

Treatment of Cushing’s disease depends on multiple factors, including size and location of the tumor, age and overall health condition of the patient. Treatment options include:

Minimally Invasive Endoscopic Transsphenoidal Surgery
Orange County neurosurgeon Robert Louis, MD, specializes in minimally invasive endoscopic transsphenoidal surgery for the treatment of Cushing’s disease. This sophisticated procedure removes the tumor while minimizing complications, hospital time, trauma and discomfort. Dr, Louis has the specialized skills and training with this advanced technique. Read more about Endoscopic Transsphenoidal Surgery.

Medications
Medications may be prescribed for patients who still suffer from the symptoms of Cushing’s disease after the surgery. Adrenal-directed medications inhibit the adrenal glands from producing steroids, which are effective in initially relieving the symptoms of Cushing’s disease. But these medicines have side-effects and are not effective in long-term cure for Cushing’s disease.

Robert Louis, MD, a fellowship-trained Orange County Neurosurgeon, is the Director of the Skull Base and Pituitary Tumor Program at Hoag Memorial Hospital in Orange County, California. Dr. Louis has particular expertise in endoscopic and minimally invasive treatment of benign and malignant brain tumors, sellar and parasellar tumors and skull base tumors.

Dr. Robert Louis specializes in minimally invasive endoscopic transsphenoidal surgery for the treatment of Cushing’s disease. For appointments, please call (949) 274-7336 or Contact Us.