Which combination of signs is commonly seen in Cushing disease?

Which combination of signs is commonly seen in Cushing disease?

• A. Moon Face, Truncal Obesity, Loss of Bone Density
• B. Weight loss, Hypoglycemia, Cold Intolerance
• C. Jaundice, Pruritus, Edema
• D. Hyperpigmentation, Telangiectasias, Edema

Answer: (A)

Excess cortisol in Cushing disease causes fat to be redistributed to the face and trunk, and it weakens bone. Moon face comes from facial fat buildup and fluid retention; truncal obesity reflects central fat accumulation; and loss of bone density represents osteoporosis from cortisol’s effects on bone turnover. The other sign sets don’t match this pattern: weight loss with cold intolerance points to adrenal insufficiency, jaundice and pruritus suggest liver/biliary disease, and hyperpigmentation is more typical of ACTH excess in Addison disease rather than Cushing. So the combination of Moon Face, Truncal Obesity, and Loss of Bone Density is the classic presentation.

Excess cortisol in Cushing disease causes fat to be redistributed to the face and trunk, and it weakens bone. Moon face comes from facial fat buildup and fluid retention; truncal obesity reflects central fat accumulation; and loss of bone density represents osteoporosis from cortisol’s effects on bone turnover. The other sign sets don’t match this pattern: weight loss with cold intolerance points to adrenal insufficiency, jaundice and pruritus suggest liver/biliary disease, and hyperpigmentation is more typical of ACTH excess in Addison disease rather than Cushing. So the combination of Moon Face, Truncal Obesity, and Loss of Bone Density is the classic presentation.