Cushing's syndrome

Alternative names:

hypercortisolism

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

Additional symptoms that may be associated with this disease:

• weight gain (unintentional)
• skin spots, red
• skin blushing/flushing
• muscle atrophy
• fatigue
• bone pain or tenderness
• blood pressure, high

Signs and tests:

Tests to confirm high cortisol level:

• cortisol, urine
• creatinine urine
• dexamethasone suppression test
• serial serum cortisol levels do not show diurnal variations

Tests to determine the cause:

• ACTH
• cranial MRI or cranial CT scan may show pituitary tumor
• abdominal CT may show adrenal mass
• general findings:
• glucose test is elevated
• potassium test may be low

This disease may also alter the results of the following tests:

• sodium, urine
• potassium; urine
• glucose - urine
• calcium; urine
• 24 hours urinary aldosterone excretion rate
• 17-ketosteroids
• 17-hydroxycorticosteroids
• serum sodium
• glucose tolerance test
• CO2
• serum chloride
• aldosterone