What are the symptoms of Cushing's syndrome?

From the Guidelines

Cushing's syndrome is characterized by a constellation of classic symptoms, including mood disorders, menstrual irregularities, muscle weakness, weight gain, abdominal striae, hirsutism, dorsal and supraclavicular fat, and fragile skin.

Common Symptoms

• Mood disorders
• Menstrual irregularities
• Muscle weakness
• Weight gain
• Abdominal striae
• Hirsutism
• Dorsal and supraclavicular fat
• Fragile skin

Associated Conditions

• Glucose abnormalities
• Hypertension These symptoms and signs are caused by chronic excessive glucocorticoid exposure from endogenous or exogenous sources, leading to a condition that mimics a severe form of the metabolic syndrome 1. The diagnosis of Cushing's syndrome involves a combination of clinical suspicion, laboratory tests, and imaging studies, with a focus on identifying the underlying cause of the excess glucocorticoids 1.

From the Research

Symptoms of Cushing's Syndrome

The symptoms of Cushing's syndrome are varied and can be divided into several categories, including:

• Metabolic symptoms:
  • Obesity
  • Hyperglycemia
  • Hypertension
  • Dyslipidaemia
  • Metabolic syndrome 2, 3, 4, 5
• Musculoskeletal symptoms:
  • Myopathy
  • Osteoporosis
  • Skeletal fractures
  • Muscle atrophy 3, 4
• Neuropsychiatric symptoms:
  • Impairment of cognitive function
  • Depression
  • Mania
  • Mood disorders 2, 3, 5
• Dermatological symptoms:
  • Acne
  • Hirsutism
  • Alopecia
  • Skin atrophy
  • Excessive bruising
  • Purple striations
  • Poor wound healing
  • Facial plethora
  • Vellous hypertrichosis 3, 4, 5
• Reproductive and sexual symptoms:
  • Impairment of reproductive and sexual function
  • Hypogonadism 3, 4
• Other symptoms:
  • Facial rounding
  • Dorsocervical fat pad
  • Thin skin 5

Clinical Presentation

The clinical presentation of Cushing's syndrome can be variable, and some symptoms are common in the general population, making diagnosis challenging 2, 5. The syndrome is associated with severe multisystem morbidity, including impaired cardiovascular and metabolic function, infections, and neuropsychiatric disorders, which can reduce quality of life and increase mortality 2, 3.