What is the Difference Between Cushings Disease and Cushings Syndrome

The key difference between Cushings disease and Cushings syndrome is that Cushing’s disease is due to excess cortisol made in the body as a result of a pituitary tumor within the brain, while Cushing’s syndrome is due to excess cortisol that comes from outside the body through medications or made in the body as a result of a pituitary or adrenal gland tumor.

ACTH (adrenocorticotropic hormone) is a hormone secreted by the pituitary gland, located at the base of the brain. It controls the production of another hormone known as cortisol. Cortisol is produced by adrenal glands, which are located above the kidney. Cortisol plays a vital role in helping people to respond to stress, fight infection, maintain blood glucose, and regulate metabolism. Cushing’s disease and Cushing’s syndrome are two medical conditions that are due to too much cortisol hormone in the body.

CONTENTS

1. Overview and Key Difference
2. What is Cushings Disease 
3. What is Cushings Syndrome
4. Similarities – Cushings Disease and Cushings Syndrome
5. Cushings Disease vs Cushings Syndrome in Tabular Form
6. Summary – Cushings Disease vs Cushings Syndrome

What is Cushings Disease?

Cushing’s disease is s disease caused due to a pituitary tumor secreting excessive ACTH hormone. It is a rare disease that affects 10 to 15 in a million each year. It also occurs more commonly in adults between 20 to 50 years of age. Normally, women account for more than 70 percent of cases. Patients with Cushing’s disease have small tumors in the pituitary called pituitary microadenomas (sometimes large tumors or macroadenomas). Cushing’s disease is used to describe a medical condition of excessive cortisol in the body arising from a pituitary tumor secreting the hormone ACTH.

The symptoms may include fullness or rounding of the face, added fat on the back of the neck, easy bruising of skin, purplish stretch marks, excessive weight gain, red cheeks, excess hair growth in the face, neck, chest, general weakness, menstrual disorders, high blood pressure, diabetes mellitus, mood and behaviour disorders, etc. The large tumors or macroadenomas in the pituitary can cause visual loss, hypopituitarism, elevation of blood prolactin level, etc. The diagnosis of this medical condition is through physical examination, hormone testing, MRI, or inferior petrosal sinus sampling. Treatment options include surgically removing pituitary adenomas, medications to reduce adrenal gland production of cortisol, radiation, or bilateral adrenalectomy.

What is Cushings Syndrome?

Cushing’s syndrome is due to excess cortisol that comes from outside the body through medications or excess cortisol made in the body as a result of a pituitary or adrenal gland tumor. The most common cause of Cushing’s syndrome is the long-term use of cortisol doses like glucocorticoids. These medicines are used to treat conditions such as asthma, rheumatoid arthritis, and lupus. Several tumors such as pituitary tumors, ectopic ACTH producing tumors, or adrenal gland tumors may also cause Cushing’s syndrome.

The symptoms may include weight gain, thin arms and legs, a round face, increased fat around the base of the neck, fatty hump between shoulders, easy bruising, wide purple stretch marks, and weak muscles. The diagnosis of this condition can be made through 24-hour urinary free cortisol test, late-night salivary cortisol test, low dose dexamethasone suppression test (LDDST), dexamethasone-CRH test, blood test, MRI scan, CT scan, and petrosal sinus sampling. The treatment options include surgically removing tumors, radiation, removing adrenal glands, drugs to reduce excessive production of cortisol includes ketoconazole, mitotane, metyrapone, mifepristone.

What are the Similarities Between Cushings Disease and Cushings Syndrome?

• Cushing’s disease and Cushing’s syndrome are two medical conditions that are due to too much cortisol hormone in the body.
• Both conditions are named after the neurosurgeon Harvey Cushing, who first described these conditions in 1912.
• These conditions may have excessive production of ACTH hormone.
• Both conditions can be due to sporadic and inherited genetic mutations.
• They produce similar symptoms and can be treated with similar treatment options.
• In both conditions, women are affected more than men.

What is the Difference Between Cushings Disease and Cushings Syndrome?

Cushing’s disease occurs due to excess cortisol made in the body as a result of a pituitary tumor within the brain while Cushing’s syndrome occurs due to excess cortisol that comes from outside the body through medications or made in the body as a result of a pituitary or adrenal gland tumor. Thus, this is the key difference between Cushing’s disease and Cushing’s syndrome. Furthermore, Cushing’s disease is due to mutations in genes such as Menin 1, NR3C1, AIP, TP53, and NR0B1. On the other hand, Cushing’s syndrome is due to mutations in genes such as CTNNB1, APC, PRKACA.

The below infographic presents the differences between Cushings disease and Cushings syndrome in tabular form for side by side comparison.

Summary – Cushings Disease vs Cushings Syndrome

Cushing’s disease and Cushing’s syndrome are two medical conditions that are due to too much cortisol hormone in the body. Cushing’s disease is due to excess cortisol made in the body as a result of a pituitary tumor within the brain while Cushing’s syndrome is due to excess cortisol that comes from outside the body through medications or made in the body as a result of a pituitary or adrenal gland tumor. So, this is the key difference between Cushings disease and Cushings syndrome.

Reference:

1. “Cushing’s Disease.” UCLA Pituitary and Skull Base Tumor Program.
2. “Cushing’s Syndrome.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services.

Image Courtesy:

1. “CushingsFace” By Ozlem Celik, Mutlu Niyazoglu, Hikmet Soylu and Pinar Kadioglu – http://mrmjournal.biomedcentral.com/articles/10.1186/2049-6958-7-26 (CC BY 2.5) via Commons Wikimedia
2. “Cushing’s syndrome” By Mikael Häggström – Own work (CC0) via Commons Wikimedia