Cushing’s disease /ko͝osh″ingz/ [Harvey W. Cushing, American neurosurgeon, 1869–1939] , a metabolic disorder characterized by abnormally increased secretion of adrenocortical steroids, particularly cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) secreted by the pituitary, such as by a pituitary adenoma. Also called hyperadrenalism. Compare Cushing’s syndrome. ▪ OBSERVATIONS: Excess adrenocortical hormones result in accumulations of fat on the abdomen, chest, upper back, and face and occurrence of edema, hyperglycemia, increased gluconeogenesis, muscle weakness, acne, purplish striae on the skin, decreased immunity to infection, osteoporosis with susceptibility to bone fractures, and facial hair growth in women. Diabetes mellitus may become a chronic condition. ▪ INTERVENTIONS: Therapy is aimed at removal or destruction of ACTH-secreting tissue, most commonly by surgical or radiological procedures. The adrenal glands may be totally or subtotally removed and pharmacological preparations of adrenal steroids administered. ▪ PATIENT CARE CONSIDERATIONS: Cushing’s disease affects many systems, and a team approach will assist the patient in coping with system changes. The chronic nature of the disease mandates education so that the patient is able to monitor symptoms and responses to medications. Changes in appearance and hormonal changes may affect the patient’s emotional well-being. Assessment of the patient’s level of activity and ability to carry out routine and self-care activities is important.
