Cushing Disease

Cushing disease is an endocrine disorder characterized by increased adrenocorticotropic hormone (ACTH) production from the anterior pituitary, leading to excess cortisol release from the adrenal glands. A pituitary adenoma often causes this, or it results from excess production of corticotropin-releasing hormone (CRH) from the hypothalamus. Symptoms of the disease include generalized weakness, high blood pressure, diabetes mellitus, menstrual irregularities, or psychiatric changes. Physical manifestations of excess cortisol levels include moon facies, buffalo hump, easy bruising, abdominal striae, obesity, facial plethora, and hirsutism (see Cushing Syndrome). A key feature is that many patients with Cushing disease do not present with bitemporal hemianopsia because most lesions are pituitary microadenomas (less than 10mm in size).