What are the most specific signs of Cushing syndrome?

The most specific (but less sensitive) signs are: wide purple striae (above 1 cm), proximal myopathy, easy bruising, and osteoporosis in a young patient. Obesity and hypertension alone have low specificity as they are common.

What is the most common cause of Cushing syndrome?

Exogenous glucocorticoids (iatrogenic) are the most common cause overall. Of endogenous causes: pituitary ACTH-secreting adenoma (Cushing disease) accounts for 70%, ectopic ACTH secretion 10%, and adrenal tumors 20%.

Who should be screened for Cushing syndrome?

Screening is recommended for: patients with unusual features for age (osteoporosis in young patients), multiple features simultaneously (hypertension + diabetes + obesity in young adults), adrenal incidentaloma, and children with weight gain plus height deceleration.

Cushing Syndrome Probability Score

Estimate pre-test probability of Cushing syndrome based on clinical features: easy bruising (most specific), plethora, proximal myopathy, striae above 1cm, and hypertension in young patients.

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Cushing Syndrome Probability Score

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Frequently Asked Questions

What are the most specific signs of Cushing syndrome?

What is the most common cause of Cushing syndrome?

Who should be screened for Cushing syndrome?