Non-modifiable Modifiable

 Age : 20 – 50 years  Chronic use of corticosteroid

old medication
 Sex : Female (much  Pituitary micro adenoma
more common in  Tumor in the adrenal
women)  Multiple endocrine neoplasia type I
 Ectopic ACTH secreting tumor
 Irregular sleep pattern
 Asthma
 Rheumatoid Arthritis
 Depression, alcoholism, &
malnutrition
 Trained athletes

Growth of ACTH secreting tumor

Synthesis and increased secretion of ACTH

ACTH stimulate adrenal cortex to secrete cortisol

Synthesis and secretion of cortisol

Increased cortisol

Suppression of cortisol and ACTH secretion

Decreased level of ACTH

Atrophy of remaining adrenal cortex

Alteration of remaining adrenal cortex

Alteration of cortisol secreting activity

Prolonged and excessive cortisol level

CUSHING’S SYNDROME