Cushing's Syndrome

Symptoms

The signs and symptoms of Cushing's syndrome vary and most often develop gradually. You may have:

• Weight gain. Symptoms may include a round or puffy face (moon face), increased fat around the neck and upper part of the back (buffalo hump), or an enlarged waistline. Weight gain is the most common symptom of Cushing's syndrome.
• Skin changes. These include thin, fragile skin that bruises easily; slow-healing wounds; wide, purplish stretch marks on the body (striae); acne; or a ruddy complexion.
• Changes in mental state. Irritability, anxiety, inability to sleep (insomnia), or feelings of sadness or depression may develop.
• Muscle and bone weakness. Symptoms may include backache; broken bones, especially the ribs and spine (caused by osteoporosis); or loss of muscle tone and strength. Weakness of the muscles in the arms and legs may make it difficult to rise from a chair or climb stairs.
• Sex hormone changes.Menstrual irregularity, facial hair growth in women, erection problems (erectile dysfunction), or loss of sex drive may occur.
• High blood pressure and diabetes.High blood pressure (hypertension) and diabetes may not be diagnosed until you have a checkup.

The eye conditions glaucoma and cataracts also may develop in Cushing's syndrome. In Cushing's disease (tumours on the pituitary gland), your field of vision can be affected; you may have loss of side, or peripheral, vision.

If a cancerous tumour on the lung is the cause, you may have rapid loss of appetite (anorexia) and weight loss. You also may develop dark spots on the skin (hyperpigmentation).

Not everyone who has the classic signs and symptoms of Cushing's syndrome has the disorder. Also, not everyone who has Cushing's syndrome has the classic changes in physical appearance; this is especially true in people who are very physically active.

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Author:	Douglas Dana Robin Parks, MS	Last Updated: August 28, 2006
Medical Review:	Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism
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