please help with this case - small_doctor

[ArchivalUser]

male patient aged 22 years old,medical student,complaining from purple reddish striea on his abdomen and flanks.
blood pressure 130/90.with visible suprastrnal pulsations.
investigation done and relieved the following
fasting blood sugar----?73.6 mg%
post prandial blood sugar--->115.8 mg%
urine sugar.acetone,albumin---->nil
ACTH am---?21.8 pg/ml
ACTH pm----?29.1
serum cortisol am--->13.9 ug/dl
serum cortisol pm---?15.2 ug/dl
serum potassium--->3.1 mmol/ml
what is the most accepted diagnosis?
please help
i suggest it may be cushing syndrome or anixety disorder(cortisol anti stress) waiting for ur feed back
thanx

[ArchivalUser]

any one here ??!!

[ArchivalUser]

I dont know!!

[ArchivalUser]

thanx for ur reply
i reall confused with this case

[ArchivalUser]

it sounds like cushing to me as there is not much diurnal variation in cortisol in am and pm

[ArchivalUser]

thanx
more relpys please

[ArchivalUser]

the normal diurnal variation is
-under ACTH influence
-Highest cortisol in early am
-Lowest cortisol in late pm

In this case low in am and high in pm

Glucocorticoid excess causes cutaneous striae
Glucose is normal

your medical school stay late craming books , stressed and increase his ACTH and Corticol

Stress related cushing's syndrome.

[ArchivalUser]

I mean med school student sorry 4 typo

[ArchivalUser]

thanx okt3 for ur opinion
so how we mange this case?