Ross and Linch listed clinical signs and symptoms which can be used to suspect Cushing's syndrome in a patient. Early diagnosis with treatment can reduce the long-term cardiovascular morbidity and mortality. The authors are from University College London.



(1) weight gain

(2) lethargy

(3) depression

(4) headache

(5) thirst and urinary frequency

(6) backache

(7) muscle weakness

(8) shortness of breath

(9) recurrent infections

(10) abdominal pain

(11) loss of scalp hair (may be more noticeable in women)



• Headache may be a feature of a pituitary adenoma.

• Thirst and urinary frequency may be related to diabetes mellitus, below.


Symptoms in women:

(1) menstrual irregularities

(2) hirsutism


Symptoms in men:

(1) loss of libido

(2) impotence



(1) hypertension

(2) obesity, which may be truncal or generalized

(3) plethora

(4) facial rounding

(5) easy bruisability

(6) striae

(7) buffalo hump

(8) ankle edema

(9) acne

(10) skin pigmentation

(11) abnormal glucose tolerance or diabetes mellitus

(12) osteoporosis with or without fractures

(13) renal calculi


The presence of multiple signs and symptoms should prompt appropriate laboratory testing and imaging studies.


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