Most people with Cushing syndrome will have:

• Upper body obesity (above the waist) and thin arms and legs
• Round, red, full face (moon face)
• Slow growth rate in children

Skin changes that are often seen:

• Acne or skin infections
• Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
• Thin skin with easy bruising

Muscle and bone changes include:

• Backache, which occurs with routine activities
• Bone pain or tenderness
• Collection of fat between the shoulders (buffalo hump)
• Thinning of the bones, which leads to rib and spine fractures
• Weak muscles

Women with Cushing syndrome often have:

• Excess hair growth on the face, neck, chest, abdomen, and thighs
• Menstrual cycle becomes irregular or stops

Men may have:

• Decreased fertility
• Decreased or no desire for sex
• Impotence

Other symptoms that may occur with this disease:

• Mental changes, such as depression, anxiety, or changes in behavior
• Fatigue
• Headache
• High blood pressure
• Increased thirst and urination

Blood sugar and white blood cell counts may be high. Potassium level may be low.

Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are:

• Serum cortisol levels
• Salivary cortisol levels
• Dexamethasone suppression test
• 24-hour urine for cortisol and creatinine
• ACTH level
• ACTH (cosyntropin) stimulation test

Tests to determine the cause or complications may include:

• Abdominal CT
• ACTH test
• Pituitary MRI
• Bone density, as measured by dual x-ray absorptiometry (DEXA)

High cholesterol, including high triglycerides and low high-density lipoprotein (HDL) may also be present.