Question: If someone is having a recurrence of Cushing’s Disease, will the symptoms be the same as the original Cushing’s? What symptoms should we be looking for?
Answer: Patients who experience a recurrence of Cushing’s are often more perceptive of changes the second time and are often accurate in suspecting a recurrence. In my clinical experience, sometimes the patient’s symptoms occur before development of abnormal tests (24 hour urine free cortisol, nighttime salivary cortisol levels, 1 mg overnight dexamethasone test). I have learned to pay close attention to patient reports of changes, and to obtain serial tests to either confirm or exclude recurrence of Cushing’s. One important symptom of recurrence is sleep disturbance and new onset of feeling more irritable. Other features of recurrence include unexplained weight gain, new onset or worsening control of diabetes or new onset hypertension or worsening control of blood pressure. However, most patients note the problems with mood and sleep as early indicators.
By Dr. Mary Lee Vance, MD, Professor of Medicine and Neurosurgery, University of Virginia, Spring, 2017