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Endocrine enigmas

Is it simple obesity and hypertension, or Cushing’s disease?

Pat Phillips

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Abstract

You suspect Cushing’s syndrome in your overweight patient who has hypertension and a florid appearance. What should you do next?

Article Extract

Case scenario

‘Robyn’ is new to you and is seeing you to re-check her blood pressure. On a previous visit to your colleague, Robyn’s blood pressure was 152/96 mmHg. Given her family history (father developing diabetes at age 45 and dying of a myocardial infarct at age 51), her being overweight (weight 75 kg, height 160 cm, BMI 29.3 kg/m2 [overwight BMI is 25 to 30 kg/m2]) and her age of 46, your colleague and Robyn were concerned about her future risk of heart disease.

Her blood pressure is still high (150/94 mmHg), but you are struck by her florid appearance (Figure 1) and wonder if she has Cushing’s syndrome as the cause of her hypertension and overweight.

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