Symptoms:

Most people with Cushing syndrome will have:

• 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 with Cushing syndrome 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 with this disease:

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

Signs and tests:

Blood sugar and white blood cell counts may be high. Potassium level may be low.

Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are:

• Serum cortisol levels
• Salivary cortisol levels
• Dexamethasone suppression test
• 24-hour urine for cortisol and creatinine
• ACTH level
• ACTH (cosyntropin) stimulation test

Tests to determine the cause or complications may include:

• Abdominal CT
• ACTH test
• Pituitary MRI
• Bone density, as measured by dual x-ray absorptiometry (DEXA)

High cholesterol, including high triglycerides and low high-density lipoprotein (HDL) may also be present.