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OCR: cted When investigating a patient with susp ssary: Cushing's syndrome, two stages are nec S confirmation of the presence of Cushin gnosis of syndrome and, if present, differential di ies upon the precise cause. The diagnosis of Cushing's syndrome r ecretion the demonstration of excessive cortisol and abnormal feedback regulation of th hypothalamic-pituitary-adrenal axis. eliable No clinical features provide uniformly syndrome, differentiation between the causes of th diabetes but unequivocal pigmentation, clinical okalaemia mellitus, and especially unprovoked hy CTH strongly suggest the presence of ectopic of secretion. Virilisation may be indicative r. androgen secretion by an adrenal tumor