The described signs are most consistent with which disorder?

The described signs are most consistent with which disorder?

• A. Cushing disease
• B. Addison disease
• C. Multiple sclerosis
• D. Kaposi sarcoma

Answer: (A)

The signs described point to excess cortisol effects on the body, which produce a distinctive pattern of change: increased blood sugar, protein breakdown leading to proximal muscle weakness, and redistribution of fat with a rounded face, a trunkal (central) obesity pattern, a dorsocervical fat pad, and often purple abdominal stretch marks and easy bruising. These are hallmark features of Cushing disease, which is caused by an ACTH-secreting pituitary tumor driving elevated cortisol levels. This makes Cushing disease the best fit for the described signs. In contrast, Addison disease would present with low cortisol, leading to weakness, fatigue, hypotension, weight loss, and hyperpigmentation. Multiple sclerosis presents with neurologic deficits from demyelination, not the systemic signs of cortisol excess. Kaposi sarcoma presents with violaceous skin lesions associated with immunocompromise, not the metabolic and cosmetic changes seen with hypercortisolism.

The signs described point to excess cortisol effects on the body, which produce a distinctive pattern of change: increased blood sugar, protein breakdown leading to proximal muscle weakness, and redistribution of fat with a rounded face, a trunkal (central) obesity pattern, a dorsocervical fat pad, and often purple abdominal stretch marks and easy bruising. These are hallmark features of Cushing disease, which is caused by an ACTH-secreting pituitary tumor driving elevated cortisol levels. This makes Cushing disease the best fit for the described signs.

In contrast, Addison disease would present with low cortisol, leading to weakness, fatigue, hypotension, weight loss, and hyperpigmentation. Multiple sclerosis presents with neurologic deficits from demyelination, not the systemic signs of cortisol excess. Kaposi sarcoma presents with violaceous skin lesions associated with immunocompromise, not the metabolic and cosmetic changes seen with hypercortisolism.