Question

Explain why corticosteroid usage is the most common cause of Cushing-like symptoms.  How does use of corticosteroids lead to adrenal atrophy?

Answer 1

The most comman cause of Cushing syndrome is exogenous production of cortisol . As we know that corticosteroid are used in variety of disorder like in inflammatory condition , to avoid graft rejection , in rheumatoid arthritis

As we prolonged the uses of corticosteroid it causes increase in production of cortisol which is is the main cause of cushing like syndrome

This type of cause of Cushing syndrome is known as exogenous Cushing syndrome . The increased level of cortisol due to long term use and high dose use of corticosteroid (glucocorticoid)

The use of corticosteroid leads to adrenal atrophy because

When there is chronic use of corticosteroid the exogenous glucocorticoid cause suppression of corticotropin releasing hormone and adrenocorticotropic hormone which causes adrenal atrophy . The adrenal gland physically get shrink . During chronic use of corticosteroid it inhibit hypothalamic- pituitary adrenal axis which leads to adrenal insufficiency .

That's why it is indicated to stop the corticosteroid slowly because there is adrenal atrophy . Which has to be recovered after the discontinuation of corticosteroid

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