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Endocrine glands Striae in the popliteal fossa Striae on the leg

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Pituitary Cushing’s (Cushing’s disease)

Symptoms: Moon face (round, red, and full) Buffalo hump (a collection of fat on the back of the neck) Central obesity with protruding abdomen and thin extremities Weight gain Weakness Backache Headache Acne or superficial skin infections Thirst Increased urination Purple striations on the skin of the abdomen, thighs, and breasts Mental changes Impotence or cessation of menses Excessive hair growth in females Signs and tests: Tests are done to confirm hypercortisolism, then to determine the cause. In general, the fasting glucose may be elevated (glucose intolerance), and serum potassium may be low. These tests confirm hypercortisolism: 24 hour curine cortisol 24-hour urine creatinine Dexamethasone suppression test (low dose) Serial serum cortisol levels that do not show diurnal variation Nighttime saliva cortisol levels These tests determine cause: Serum ACTH levels Cranial MRI scan that shows a pituitary tumor CRH test Petrosal sinus sampling Dexamethasone suppression test (high dose) Text Continues Below

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