Pseudo-Cushing’s syndrome

Perform initial screening tests to confirm Cushing s syndrome and rule out those with pseudo-Cushing s conditions (in other words, until it is determined that it is not a pseudo-Cushing s syndrome). 

Excessive alcohol intake can cause pseudo-Cushing s syndrome when patients may present with hypertension, truncal obesity, plethora or acne. Preliminary investigations may demonstrate hypercorti.solism which may fail to suppress with dexametha.sone. The biochemical features of Cushing s syndrome will resolve after two to three weeks abstinence. 

True Cushing s syndrome also must be distinguished from other conditions that share some clinical presentations (as well as elevated plasma cortisol concentrations), such as depression, alcoholism, obesity, and chronic illness—the so-called pseudo-Cushing s states. 

Newell-Price J, Trainer P, Besser M, Grossman A. The diagnosis and differential diagnosis of Cushing s syndrome and Pseudo-Cushing s states. Endocr Rev 1998 19 647-672. 

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