Symptoms

Excess secretion of cortisol can lead to chronic disorders, such as hypertension and glucose intolerance (Newell-Price et al., 2006). If left untreated, CS can become life-threatening as a result of systemic complications (Resmini, 2014). 

The symptoms of CS differ from patient to patient, may present in a cyclical fashion and frequently mimic those of other conditions, leading to difficulties in diagnosis. In addition, clinical presentation can vary by sex and by age (Newell-Price et al., 2006)

These difficulties in diagnosis often lead to delayed treatment, which can have a significant impact on patient health. Delayed diagnoses can result in irreversible organ damage, and in some cases, prevent the early diagnosis of malignancies. Untreated Cushing’s Syndrome is associated with 50% mortality at 5 years, predominantly from cardiovascular events, or overwhelming infection (Prague et al., 2013).

The most common symptoms of CS include:

 Clinical characteristics of Cushing’s Syndrome

Figure 3. Clinical characteristics of Cushing’s Syndrome (Newell-Price et al, 2006; Patel et al. 2011).

However, many of these problems are seen in patients without CS, so symptoms and signs of high specificity should be sought: these include easy bruising, a thin skin, myopathy, osteoporosis in an obese individual, and growth failure in an obese child. 

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