? Cushing + 1st episode gtcc

? Cushing syndrome Chief Complaints 1st episode of gtcc History 14 yr fm moon facies central obesity no obesity in parents excessive hairs over hands ? small/absent uterus in usg abd/kub pain threshold low, good intellectual capacity vitally stable cect brain nad cbc normal rft normal bp 100/70 fbs 80 serum cortisol normal ? Cushing ? kindly give next approach

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SIS CUSHING SYNDROME WITH GTCC SEIZURE .......MOON FACE , ABDOMINAL PROTUBERANCE NEED CORTISOL LEVEL ? SEX HORMONE STUDY ? HB1AC? BP? ACTH? CT SCAN ? ADRENAL GLAND TUMOR Rx ANTI-CORTISOL MEDICATION MIFEPRISTONE ANTI-HTN DRUGS DM MEDICATION EXERCISE IF TUMOR NEED SURGICAL INCISION OR RADIATION & MEDICATION TRANSSPLENOIDAL SX ENDOCRINOLOGIST OPINION

bp 100/70 fbs 80 serum cortisol normal
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Harmonal study required Morning cortisol ACTH CT scan PET scan for any adrenal gland of abdomen Take opinion of Endocrinologist

Do morning cortisol, ACTH, CT abdomen to rule out any adrenal tumour secreting cortisol.. And as per the results go with further treatment plan.... supportive care and exercise plays a major and weight loss plays a major role after monitoring BP

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