Medicine (MD/DO)
Adrenal Disorders
Cushing's Syndrome Symptoms And Diagnosis

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Cushing's Syndrome Symptoms And Diagnosis

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Cushing's Syndrome Symptoms And Diagnosis

Patients with Cushing syndrome have a characteristic look- they have central obesity that manifests as truncal obesity, buffalo hump and moon facies. They often present with hypertension and may have osteoporosis and skin thinning due to bone and collagen resorption, respectively.
Ostrich-with-porous bones

As osteoblast activity is inhibited, patients with prolonged Cushing syndrome can develop osteoporosis.


Excess cortisol influences other hormones, and in women leads to increased androgens. This presents as amenorrhea or oligomenorrhea in female patients.

Truncal Obesity
Trunk Fat

Patients develop rapid weight gain, which manifests as central or truncal obesity.

Skin Changes
Changing into Skin-suit

In Cushing syndrome, skin tends to become thin, fragile, and more susceptible to infections and bruising. Abdominal striae also develop, due to skin stretching and hemorrhage.

Buffalo Hump
Buffalo Hump

A common distribution of weight gain in patients with Cushing syndrome is in the upper back and base of the neck. This pattern of weight gain is called a "buffalo hump."

Immune Suppression
Moon Suppressed

As increased cortisol suppresses the immune system, people with Cushing syndrome are more prone to developing infections.

Moon Facies

Development of Cushing syndrome may cause patients to have fat collection in the face. This distribution pattern is called a "moon face."


Patients also display persistent hypertension, as cortisol enhances epinephrine's vasoconstrictive effects.

Decreased Insulin Sensitivity
Down-arrow Insect-syringe with Sensitive-tears

Cortisol excess can cause insulin resistance, when can eventually develop into type II diabete mellitus.

24-hour urine free Cortisol
24-hour-clock Urinal with Court-of-Sol

Diagnosis of Cushing syndrome can be made with a 24-hour urine free Cortisol test. This helps discover high levels of Cortisol in patient circulation.

Dexamethasone Suppression Test
Desk-moth Suppressed

The dexamethasone suppression test is very helpful in diagnosing Cushing syndrome. This is because through administration of dexamethasone and frequent determination of cortisol and ACTH level, the etiology of excess cortisol secretion can be found.


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