Endocrine enigmas

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

Endocrine enigmas

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

Pat Phillips

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.