Symptoms:

Symptoms usually include:

• Upper body obesity (above the waist) and thin arms and legs
• Round, red, full face (moon face)
• Slow growth rate in children

Skin changes that are often seen:

• Acne or skin infections
• Purple marks (1/2 inch or more wide), called striae, on the skin of the abdomen, thighs, and breasts
• Thin skin with easy bruising

Muscle and bone changes include:

• Backache, which occurs with routine activities
• Bone pain or tenderness
• Collection of fat between the shoulders (buffalo hump)
• Thinning of the bones, which leads to rib and spine fractures
• Weak muscles

Women often have:

• Excess hair growth on the face, neck, chest, abdomen, and thighs
• Menstrual cycle becomes irregular or stops

Men may have:

• Decreased fertility
• Decreased or no desire for sex
• Impotence

Other symptoms that may occur include:

• Mental changes, such as depression, anxiety, or changes in behavior
• Fatigue
• Headache
• High blood pressure
• Increased thirst and urination

Signs and tests:

In people who use cortisone, prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:

• Low ACTH level
• Low cortisol level
• No response to a cosyntropin stimulation test
• Higher than normal fasting glucose
• Low blood potassium level
• Low bone density, as measured by dual x-ray absorptiometry (DEXA)
• High cholesterol, particularly high triglycerides and low high-density lipoprotein (HDL)

A method called high performance liquid chromatography (HPLC) can show high levels of the suspected medication in the urine.