38 Year Old Male (Known Case Of COPD) Presents With Weight Gain

This 38 years old man presents with unintentional weight gain over the past few months. He is a known case of COPD and is on steroid medicines.

Case Discussion:
Cushing Syndrome:

A condition that results from hypercortisolism and the most common cause is exogenous steroid use.

Clinical features:
Patients has typical features of truncal obesity with moon facies and a buffalo hump. Other signs and symptoms include hypertension, psychiatric disturbances, impotence, hirsutism, easy brusibility and purple striae.

Diagnosis:
1. Elevated 24 hour urine cortisol is diagnostic for cushing 's syndrome.
2. Low DHEA is seen only with exogenous steroids.
3. Morning serum ACTH levels are < 5 pg/ml in exogenous steroids or adrenal adenoma.


Treatment:
1. Stop or minimize exogenous steroid use.
2. surgical resection of the tumor responsible for excess hormone production..