Yes, Please Provide the Symptom List
Yes, please provide the complete list of your patient's symptoms, as this information is essential for evaluating suspected cyclical Cushing's syndrome. 1
Key Information to Include
When describing your patient's symptoms, the following details will be most helpful for diagnostic assessment:
Core Clinical Features to Report
Weight and distribution changes: Specifically note if there has been rapid weight gain with central (truncal) distribution, facial rounding ("moon face"), dorsocervical fat pad ("buffalo hump"), or supraclavicular fat accumulation 1
Skin manifestations: Document presence of wide (≥1 cm) purple/violaceous striae, easy bruising, thin skin, facial plethora, or hirsutism 1, 2
Musculoskeletal symptoms: Note any proximal muscle weakness (difficulty climbing stairs or rising from a chair), bone pain, or history of fractures 1, 3
Metabolic disturbances: Report presence of hyperglycemia, new-onset or worsening diabetes, or hypertension 1, 2, 4
Neuropsychiatric features: Include depression, anxiety, cognitive dysfunction, mood changes, or sleep disturbances 2, 4, 3
Critical Timing Information for Cyclical Disease
Pattern of symptom fluctuation: Describe whether symptoms wax and wane over time, as cyclical Cushing's syndrome presents with periods of hypercortisolism alternating with normal or low cortisol periods 1
Duration and frequency: Note how long symptoms have been present and whether there are identifiable cycles 1
Additional Relevant Details
Cardiovascular complications: Report any thromboembolic events, arrhythmias, or cardiovascular disease 3
Infectious history: Note any recurrent or opportunistic infections, as hypercortisolism causes immunosuppression 1, 2
Medication history: Critically important to document any exogenous glucocorticoid use, as this is the most common cause of Cushing's syndrome and must be excluded first 2, 4
Once you provide this symptom profile, I can guide you through the appropriate diagnostic algorithm and screening tests recommended by the ACC/AHA and Endocrine Society guidelines. 1