Clinical Manifestation of Cushing Syndrome

Moon facies Proximal myopathy

Central obesity Hypertension
Buffalo hump Glucose intolerance/ diabetes
Thin and brittle skin, easy Dyslipidemia
bruisability
Emotional liability, depression
Broad and purple stretch marks
Decreased libido
Osteopenia, osteoporosis,
vertebral fractures
 Clinical Manifestation of Addison's Disease
Generally nonspecific and constitutional- profound fatigue and anorexia.

Hyperpigmentation, a hallmark of primary adrenal insufficiency, results from

high serum concentrations of ACTH in response to increased hypothalamic
release of proopiomelanocortin (POMC)-derived peptides that stimulate the
melanocortin (MC-1) receptor of the skin.

Acute adrenal insufficiency, or adrenal crisis, is a life threatening condition

often preceded by hypotension unresponsive to fluid resuscitation.
 Signs and symptoms caused by glucocorticoids deficiency
 Fatigue, lack of energy
 Weight loss, anorexia
 Myalgia, joint pain
 Fever
 Postural hypotension
 Hyponatremia

 Sign and symptoms caused by mineralocorticoid deficiency ( primary

adrenal insufficiency only)
 Abdominal pain, nausea, vomiting
 Dizziness, postural hypotension
 Salt craving
 Low blood pressure, postural hypotension
 Increased serum creatinine
 Hyponatremia
 Hyperkalemia

 Sign and symptoms caused by adrenal androgen deficiency

 Lack of energy
 Dry and itchy skin (in women)
 Loss of axillary and pubic hairs ( in womens)
 Other signs and symptoms
 Hyperpigmentation( primary adrenal insufficiency only)- due to excess of
POMC derived peptides
 Alabastar colored skin ( secondary adrenal insufficiency only)- due to
deficiency of POMC derived peptides.