You suspect Cushing’s disease in a 50yo woman who has attended clinic with glycosuria, HTN
and a suggestive body habitus. Initial inv point you towards a dx of Cushing’s disease. Which of
the following findings would be against this dx?
a. A normal 8am cortisol
b. Failure to suppress morning cortisol with dexamethasone
c. HTN requiring >2 antihypertensive agents
d. Impaired growth hormone response to glucose loading
e. Unilateral adrenal enlargement
Key is E: Unilateral adrenal enlargement
Bilateral adrenal hyperplasia from an ACTH secreting pituitary adenoma.
Peak age 30-50 years, male female ratio 1:1
A low dose dexamethasone test leads to no change in plasma cortisol but 8 mg may be enough