A 32-year-old woman presented to the clinic complaining of weight gain swelling in her legs and ankles and a puffy face

A 32-year-old woman presented to the clinic complaining of weight gain swelling in her legs and ankles and a puffy face

A 32-year-old woman presented to the clinic complaining of weight gain, swelling in her legs and ankles and a puffy face. She also recently developed hypertension and diabetes type 2. She noted poor short-term memory, irritability, excess hair growth (women), red-ruddy face, extra fat around her neck, fatigue, poor concentration, and menstrual irregularity in addition to muscle weakness. Given her physical appearance and history, a tentative diagnosis of hypercortical function was made. Diagnostics included serum and urinary cortisol and serum adrenocorticotropic hormone (ACTH). MRI revealed a pituitary adenoma.

Question:

How would you differentiate Cushing’s disease from Cushing’s syndrome?