Cushing’s disease

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Endocrine glands

Striae in the popliteal fossa

Striae on the leg

Pituitary Cushing's disease

• Moon face (round, red, and full)
• Buffalo hump (a collection of fat on the back of the neck)
• Central obesity (person has an abdomen that sticks out and thin arms and legs)
• Weight gain
• Weakness
• Backache
• Headache
• Acne or other skin infections
• Thirst
• Increased urination
• Purple streaks on the skin of the abdomen, thighs, and breasts
• Mental changes
• Impotence
• Stopping of menstruation
• Excessive hair growth in females

Tests are done to confirm there is too much cortisol in the body, then to determine the cause. In general, the fasting glucose may be high, and serum potassium may be low.

These tests confirm too much cortisol:

• 24 hour urine cortisol
• 24-hour urine creatinine
• Dexamethasone suppression test (low dose)
• Serial serum cortisol levels that do not show diurnal (night / day) variation
• Nighttime saliva cortisol levels

• Serum ACTH levels
• Cranial MRI scan that shows a pituitary tumor
• CRH (corticotropin-releasing hormone) test -- CRH acts on the pituitary gland to bring about the release of ACTH
• Petrosal sinus sampling -- this test measures ACTH levels in the veins that drain the pituitary gland
• Dexamethasone suppression test (high dose)

Review Date: 08/08/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.