Cushing's disease is a condition of excessive production of a hormone called cortisol. Cortisol is produced in the adrenal glands in response to stimulation from another hormone called ACTH, which is secreted by the brain. Other causes of Cushing's syndrome are excessive ingestion of glucocorticoids, which are steroids that have a biochemical similarity to cortisol. Children with asthma often take these medicines. Still, Cushing's disease is rare in children.
Children with Cushing's syndrome have distinctive facial and physical characteristics. They tend to have a rounded, large face, sometimes referred to as a moon face. They also have upper body obesity, with excess fat in the trunk and neck, making their arms and legs appear slender and thin. The excess fat also tends to deposit in the upper back, giving the appearance of a hump. Children with Cushing's also tend to have a slow growth rate, and have decreased height as their weight increases.
The excess cortisol of Cushing's disease increases the production of sebum in the skin's sweat glands, increasing the probability of acne. Patients with Cushing's also develop hirsutism, or excessive hair growth. Occasionally, prolonged exposure to cortisol may lead to pronounced hair loss and balding. The skin becomes fragile and tends to bruise easily. Patients may have stretch marks in their abdomen, thighs and breasts.
Children with Cushing's syndrome exhibit a wide range of metabolic symptoms due to the excessive cortisol exposure. Patients may have weakened muscles, losing their bulk, and have brittle bones, or osteoporosis, predisposing them to easy bruising and fractures. They may have fatigue or decreased energy levels. They have high blood pressure and high blood sugar. The increased glucose in their bloodstream leads to frequent urination and increased thirst, symptoms that may be mistaken for diabetes. Teenage girls with Cushing's syndrome can have irregular periods, or they may completely stop, a condition called amenorrhea. Preadolescents with Cushing's may have a delay in the start of puberty.
About this Author
Ruben J. Nazario is a Medical and Health writer. He is board certified in Pediatrics and also has a Masters Degree in Liberal Studies from Skidmore College in Saratoga Springs, NY. He writes a medical blog for Today's Hospitalist Magazine and is the General Editor of Hospital Pediatrics, the journal for the Section of Hospital Medicine of the American Academy of Pediatrics.
Last updated on: 12/24/09
Article reviewed by Roman Tsivkin