title: Cushing's syndrome: difficulties in diagnosis.
abstract: Establishment of the precise cause in a patient with Cushing's syndrome remains a major clinical challenge. The following case of a female patient with cyclical Cushing's syndrome illustrates how recent advances such as the introduction of the corticotropin-releasing hormone (CRH) test (in determining the cause of ACTH production) and high-resolution computed tomographic scanning may help in the diagnosis of Cushing's syndrome. As this case study illustrates, precise diagnosis requires thorough initial investigation and possible successive testing.
authors.affiliation: Department of Endocrinology, St. Bartholomew's Hospital, London, U.K.
authors.forename: P J
authors.initials: PJ
authors.lastname: Trainer
authors.forename: M
authors.initials: M
authors.lastname: Besser