Case Study: 36 years old Woman with Weight Gain

MBBS
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A 36-year-old woman presents with complaints of weight gain, irregular periods, increased facial hair growth, and acne for the past year. She also notes feeling fatigued and emotionally low. On examination, she has central obesity, mild hirsutism, and purple striae on her abdomen. Her blood pressure is 150/96 mmHg. A fasting glucose test shows impaired fasting glucose. Serum cortisol levels are elevated and not suppressed after an overnight dexamethasone suppression test.

What is your provisional diagnosis? What tests would you order to confirm the source of cortisol excess? How would you differentiate between ACTH-dependent and ACTH-independent causes?

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It’s a case of endogenous cushing syndrome
To differentiate between ACTH and NON ACTH dependent we will do imaging studies like CT/MRI
To detect the growth of adrenal tissue inside the gland or outside the gland

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Cushing syndrome