Pituitary Cushing's (Cushing's disease)

Symptoms:

• moon face (round, red and full)
• buffalo hump (a collection of fat between the shoulders)
• central obesity with protruding abdomen and thin extremities
• weight gain
• weakness
• backache
• headache
• acne or superficial skin infections
• thirst
• increased urination
• purple striations on the skin of the abdomen, thighs and breasts
• mental changes
• impotence or cessation of menses
• hair, excessive on females

Signs and tests:

Tests are done to confirm hypercortisolism, then to determine the cause. In general, the fasting glucose is elevated (glucose intolerance), and serum potassium may be low.

These tests confirm hypercortisolism:

• cortisol, urine
• 24-hour urine creatinine
• dexamethasone suppression test
• serial serum cortisol levels that do not show diurnal variation

These tests determine cause:

• serum ACTH levels
• cranial MRI scan that shows a pituitary tumor