* Levels of cortisol and ACTH both elevated * 24-hour urinary cortisol levels elevated * Dexamethasone suppression test * Late night salivary cortisol (LNSC) * Loss of diurnal variation in cortisol levels (seen only in true<unk> 's Syndrome) * High mean corpuscular volume and gamma-glutamyl transferase may be clues to alcoholism * Polycystic Ovarian Syndrome should be ruled out; PCOS may have similar symptoms Differential diagnosis * Differentiation from<unk> 's is difficult, but several tools exist to aid in the diagnosis * Alternative causes of<unk> 's should be excluded with imaging of lungs, adrenal glands, and pituitary gland; these often appear normal in<unk> 's * In the alcoholic patient with<unk><unk> 's, admission to hospital (and avoidance of alcohol) will result in normal midnight cortisol levels within five days, excluding<unk> 's * Another cause for<unk> 's syndrome is adrenocortical carcinoma. This is a rare form of cancer with an incidence of 1-2 per million people annually. About 60% of these cancers produce hormones, with cortisol being the most frequent. Most patients present in an advanced disease state and the outcome is dismal.
Pseudo-Cushing's syndrome
Cushing's disease
Apparent mineralocorticoid excess syndrome
Haim–Munk syndrome
Sheehan's syndrome
Adie syndrome
Young's syndrome
Graves' disease