About this ebook
Cushing’s Syndrome
What is Cushing’s syndrome?
Cushing’s syndrome is a disease which is caused by the exposure of the body to excessive quantities of glucocorticoids steroids.
People of all ages are affected but more are seen in females between 30 to 50 years of age.
What are the causes of Cushing Syndrome?
The causes are believed to be:
1. Cushing Disease -excessive production of adrenocorticotrophin hormone (ACTH) by the pituitary gland causes bilateral adrenal (gland above kidney) hyperplasia (overgrowth of gland tissue).
The enlarged adrenal gland will produce excessive corticosteroids.
A pituitary basophile or chromphobe adenoma may be present.
2. Adrenal tumors which may be benign or malignant can produce excessive corticosteroids
3. Ectopic ACTH syndrome
Production of ACTH by a tumor such as cancer of the lung leads to adrenal hyperplasia
4. Iatrogenic -patients receiving excessive doses of corticosteroids may present as Cushing syndrome
What are the symptoms of Cushing Syndrome?
Symptoms of Cushing Syndrome:
1. Obesity predominally truncal often with pad of fat between shoulders (buffalo hump)
2. Round flat plethoric (red) face (moon face)
3. Skin is thin and bruises easily
4. Purple striae on abdomen, thighs, and shoulders.
5. Proximal myopathy leads to difficulty in getting out of chairs and walking upstairs
6. Excessive adrenal androgen secretions lead to hirsutism, amenorrhea and acne
7. Osteoporosis can lead to back pain
8. Hypertension and glycosuria (glucose in urine) are common
9. Depression and other psychiatric disturbance common
10. In children there may stunting of growth
11. Women with Cushing syndrome often have:
a. Excess hair growth on the face, neck, chest, abdomen, and thighs
b. Menstrual cycles that are irregular or stops
12. Men may have:
a. Impotence
b. Reduced or no desire for sex
How is the Diagnosis of Cushing Syndrome made?
Diagnosis of Cushing Syndrome:
1. The typical moon face and buffalo hump can suggest the diagnosis of Cushing Syndrome
2. 24 hour urine cortisol tests
3. Overnight dexamethasone suppression test
4. Plasma ACTH level
5. Chest X-ray to exclude lung cancer
6. X-ray of pituitary fossa to exclude pituitary tumors
7. Ultrasound of adrenal glands for enlargement
What are the complications of Cushing Syndrome?
Complications of Cushing Syndrome:
1. Hypertension
2. Fractures from osteoporosis
3. Stunted growth in children
What is the treatment of Cushing’s syndrome?
Treatment of Cushing’s syndrome:
Cushing's syndrome is treated by surgery, radiation treatments or drugs.
Often if there is a tumor on just one adrenal gland, the other gland often becomes smaller and stops normal hormone production
Hormone supplements are always given before any surgical treatment and should be taken for months after surgery until the second adrenal gland recovers its normal function.
1. Anti-adrenal drug such as aminogluthemide
This drug blocks the production of steroids formed from cholesterol.
It is clinically used in the treatment of Cushing's syndrome and metastatic breast cancer.
2. Bilateral adrenalectomy
3. Surgery to remove pituitary tumor
4. Surgery to remove primary neoplasm in lungs or pancreas
5. In cases of adrenal gland cancer, chemotherapy and radiation can also be used to treat the cancer.
Surgery is a last resort.
6. In iatrogenic Cushing’s syndrome, reduction of ingestion of corticosteroids to the lowest dosage possible has to done to control the illness.
TABLE OF CONTENT
Chapter 1
Cushing’s Syndrome
Chapter 2
Adrenal Tumors
Chapter 3
Corticosteroids
Chapter 4
Epilogue
Kenneth Kee
Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.Beyond his medical career, Dr. Kee is also an author.He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.Over time, he published various books, many of which provide simple and accessible guides to different health conditions.His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:"A Family Doctor's Tale"This book is a blend of Dr. Kee’s personal experiences and his reflections on being a family doctor in Singapore. It’s a great choice if you're looking for a narrative that combines both medical knowledge and human stories.“Specialized Medical Conditions”Books like **"Congestive Heart Failure: Diagnosis and Treatment"** focus on specific conditions, offering in-depth information about diagnosis, treatment options, and patient management.“Healthcare Management”Some of his works touch on broader aspects of healthcare, discussing patient care, medical ethics, and the role of the family doctor in the healthcare system“Medical Case Studies”“Case Notes from a Family Doctor": This book provides insights into real-life medical cases that Dr. Kee has encountered in his practice, offering readers a behind-the-scenes look at diagnostic processes and patient care.“Health Education”His writings aim to educate the public on maintaining health and preventing diseases, covering topics like healthy living, nutrition, and fitness“Life and death of different Cell”“Life and death of Red Blood Cell” This book describes the beginning of a red blood cell (named Red Bull) from its origin from the bone marrow and its journey around the body before its death in the spleen. Other stories told are Sperm cell, Ovum, Cancer cell etc."Singapore's Medical and Social History"**"My Personal Singapore History":** This book reflects on Singapore's development from a medical perspective, interwoven with personal stories and observations about healthcare in the country.His works are known for simplifying complex medical information, making it accessible to the general public.Dr. Kenneth Kee's books cover a wide range of health and medical topics.He is known for writing in a clear and straightforward manner, making complex medical information accessible to the general public.His works are known for simplifying complex medical information, making it accessible to the general public.If you are looking for a good starting point, "A Family Doctor's Tale" offers a well-rounded introduction to Dr. Kee’s experiences and insights.It is engaging and provides a mix of personal stories and medical knowledge, making it a good entry into his work.One of the best health tips, supported by both medical professionals like Dr. Kenneth Kee and health research, is to focus on preventive care.This means taking steps to maintain your health before problems arise.There are books on Psychological conditions (PTSD) and disorders (Depression, dementia etc) and children books on Time travelMany of his books are available on platforms like Amazon and Smashwords.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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A Simple Guide to Cushing's Syndrome and Related Conditions - Kenneth Kee
A
Simple
Guide
to
Cushing’s Syndrome
And
Related
Diseases
by
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2013 Smashwords Edition
Published By Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
to my wife Dorothy
and my children
Carolyn, Grace
and Kelvin
This book describes the Cushing Syndrome and Related Diseases such as Adrenal tumors and Corticosteroids which are seen in some of my patients in my Family Clinic.
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.