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Exogenous Cushing syndrome is a form of Cushing syndrome that occurs in people taking glucocorticoid (also called corticosteroid) hormones.
Other forms of Cushing syndrome include:
Cushing syndrome - corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndrome; Exogenous Cushing syndrome
Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone cortisol. This hormone is made in the adrenal glands.
Exogenous means caused by something outside the body. Exogenous Cushing syndrome occurs when a person takes man-made (synthetic) glucocorticoid medicines to treat a disease.
Glucocorticoids are given for many diseases, such as asthma. These medicines come in many forms, including pill, intravenous (IV), injection, enema, topical, and eyedrop.
Most people with Cushing syndrome have:
Skin changes that are often seen:
Muscle and bone changes include:
Women may have:
Men may have:
Other symptoms that may occur include:
The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months.
If you use cortisone, prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:
A method called high performance liquid chromatography (HPLC) can show a high level of the suspected medicine in the urine.
Treatment is to slowly decrease and eventually stop taking any corticosteroids. Do not stop taking any medicine without first talking to your health care provider. Suddenly stopping corticosteroids after taking them for a long time can results in an adrenal crisis.
If you cannot stop taking the medicine because of disease (for example, you need steroids to treat severe asthma), follow your doctor's instructions on how to reduce the possibility of developing complications, including:
Slowly tapering the medicine that is causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy). This may take as long as a year. During this time, you may need to restart or increase the dosage of your steroids in times of stress or illness.
These complications can generally be prevented with proper treatment.
Call for an appointment with your health care provider if you are taking a corticosteroid and you develop symptoms of Cushing syndrome.
If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.
McGee S. Cushing syndrome. In: Evidence-Based Physical Diagnosis. 3rd ed. Philadelphia, Pa: Elsevier Saunders. 2012:chap 13.
Stewart PM, Krone NP. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 15.
Susmeeta TS, Nieman LK. Cushing's syndrome: all variants, detection, and treatment. Endocrinol Metab Clin N Am. 2011;40:379-391.