Diagnosis apart from iatrogenic cause

• cortisol excess (plasma or 24-hour urinary cortisol)

• dexamethasone suppression test

• radiological localisation o MRI for ACTH-producing pituitary tumours o CT scanning for adrenal tumours

Other endocrine disorders

Acromegaly

Symptoms suggestive of acromegaly include:

• excessive growth of hands (increased glove size)

• excessive growth of tissues, e.g. nose, lips, face

• excessive growth of feet (increased shoe size)

• increased size of jaw and tongue

• general: weakness, sweating, headaches

• sexual changes including amenorrhoea and loss of libido

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