Rapid Review: Cushing’s Syndrome

Cushing’s Syndrome

• Patient will be complaining of amenorrhea, central obesity, depressive symptoms, and easy bruising
• PE will show purple striae, “moon face” (facial adiposity), “buffalo hump” (increased adipose tissue in the neck and upper back), and hypertension
• Diagnosis is made by 24-hr urine cortisol and testing ACTH levels
• Most commonly caused by hypercortisolism from ACTH-secreting pituitary tumor
• Comments: If cause is pituitary tumor, then it’s called Cushing’s disease

Sample question:

A 52-year-old woman presents with amenorrhea and weight gain, especially in the centripetal area and in the dorsocervical fat pad. Physical exam reveals striae on the abdomen and a ruddy facial complexion. Blood pressure is 153/88 mm Hg. What is the most likely diagnosis?