Cushing syndrome - exogenous

Alternative Names

Treatment

The suggested treatment is to slowly stop taking any corticosteroids. Do not stop taking any medicine without first talking to your health care provider.

If you cannot stop taking the medication because of disease (for example, if you need steroids to treat severe asthma), make every effort to reduce the possibility of developing complications.

• Treat high blood sugar aggressively with diet, medications taken by mouth, or insulin.
• Treat high cholesterol with diet or medications.
• If you will be on steroids for longer than 4-6 weeks, you may need to take medication to prevent bone loss (bisphosphonates such as alendronate or risedronate). This will reduce the risk of fractures.

Outlook (Prognosis)

Slowly withdrawing the drug causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy), although this may take as long as a year. During this time, you may need to restart taking your steroids in times of stress.

Possible Complications

• Constant discomfort
• Damage to the eyes, kidneys, and nerves due to untreated high blood sugar
• Diabetes
• High cholesterol levels
• Increased risk of heart attack from untreated diabetes and high cholesterol
• Weak bones (osteoporosis) and increased risk of fractures

These complications can generally be prevented with proper treatment.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you are taking a corticosteroid drug and you develop symptoms of Cushing syndrome.

References

Stewart PM. The Adrenal Cortex. In: Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 14.