Clinical Manifestations
- Hyperglycemia which may develop into diabetes, weight gain, central type obesity
with ―buffalo hump,‖ heavy trunk and thin extremities, fragile thin skin, ecchymosis,
striae, weakness, lassitude, sleep disturbances, osteoporosis, muscle wasting,
hypertension, ―moon-face‖, acne, increased susceptibility to infection, slow healing,
virilization in women, loss of libido, mood changes, increased serum sodium, decreased
serum potassium
- Diagnosis: Dexamethasone suppression test, ↑ Na+ ↑ glucose, ↓ K+, metabolic
alkalosis
Excessive protein catabolism occurs, producing muscle wasting and osteoporosis.
Kyphosis, backache, and compression fractures of the vertebrae may result. Retention
of sodium and water occurs as a result of increased mineralocorticoid activity,
producing hypertension and heart failure.
Virilization is characterized by the appearance of masculine traits and the recession of
feminine traits.
There is an excessive growth of hair on the face (hirsutism), the breasts atrophy,
menses cease, the clitoris enlarges, and the voice deepens.
Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is
obtained at 8 AM the next morning. Suppression of cortisol to less than 5 mg/dL
indicates that the hypothalamic–pituitary–adrenal axis is functioning properly.