Clinical Presentation and Diagnosis of Cushing’s Syndrome

Prolonged exposure to high levels of glucocorticoids results in a syndrome first described by Cushing. Harvey Williams Cushing (1869–1939) reported the clinical syndrome of amenorrhea, bruising, cutaneous striae, facial plethora, high blood pressure, hirsutism, and myopathy and attributed it to "pituitary basophilism" (1). Bishop and Close were the first to name the new syndrome after Cushing in a case recognized as such the year Cushing published his paper (2). Albright was the first to recognize the role of glucocorticoids in this syndrome (3). A few years later, excessive secretion of corticotropin (ACTH) from pituitary was shown to be the cause of Cushing's disease (4). The ectopic ACTH syndrome was described by the same person who later established the dexamethasone suppression test, the long-standing golden standard for the differential diagnosis of Cushing's syndrome (5).