Study highlights symptom overlap in Cushing’s syndrome and mild autonomous cortisol secretion

Cushing’s syndrome (CS) presents with significant phenotypic variability, making it challenging to diagnose early, according to a study that found many patients with overt CS exhibit only a few clinical signs and may have similar comorbidities as those with mild autonomous cortisol secretion (MACS).

The study included 129 patients diagnosed with various forms of CS and 48 patients exhibiting mild autonomous cortisol secretion (MACS). Researchers evaluated the number of comorbidities and clinical signs in a standardized manner at the time of diagnosis. On average, patients with overt CS presented with 2 comorbidities, while those with MACS had an average of 3 comorbidities. Hypertension was identified as the most prevalent comorbidity across all patient subtypes.

The analysis of clinical signs found that while the average number of clinical signs was 5, a significant proportion of these patients exhibited only a few symptoms, with 28% presenting with ≤3 signs. In contrast, MACS patients averaged 2 clinical signs at diagnosis.

Reference
Braun LT, Vogel F, Nowak E, et al. Frequency of clinical signs in patients with Cushing’s syndrome and mild autonomous cortisol secretion (MACS): Overlap is common. Eur J Endocrinol. 2024;lvae127. doi: 10.1093/ejendo/lvae127. Epub ahead of print. PMID: 39351910.