Clinical Follow-up Record: Cushing’s Syndrome
I. Baseline Information & Initial Profile
Patient Name: ___________________________ ID: ___________
Date of Initial Diagnosis: //____
Confirmed/Suspected Etiology: (Pituitary Cushing’s / Adrenal / Ectopic / Iatrogenic)
II. Signs and Symptoms Evaluation (Baseline vs. Follow-up)
Mark presence (X) and severity (Scale 1–5)
| Clinical Finding | Baseline | Month 3 | Month 6 | Notes (Improvement/Worsening) |
| "Moon Face" | ||||
| Dorsocervical Fat Pad (Buffalo Hump) | ||||
| Violaceous Striae (>1cm) | ||||
| Proximal Muscle Weakness | ||||
| Easy Bruising (Ecchymosis) | ||||
| Central Obesity |
III. Diagnostic & Monitoring Test Panel
| Date | Test | Result | Reference Range | Comments |
| 24h Urinary Free Cortisol | ||||
| Late-night Salivary Cortisol | ||||
| Dex. Suppression Test | ||||
| Plasma ACTH | ||||
| Serum Potassium | ||||
| HbA1c / Blood Pressure |
IV. Intervention & Treatment Plan
Procedure (if applicable): (e.g., Transsphenoidal Surgery, Adrenalectomy) Date: /
Pharmacotherapy:
Steroidogenesis Inhibitors (e.g., Ketoconazole): ________ mg/day.
Glucocorticoid Receptor Antagonists: ________________________.
Replacement Therapy (Post-op): (e.g., Hydrocortisone) ________ mg/day.
V. Patient Wellness & Subjective Experience
This section is vital for tracking the impact of cortisol on mental health and the patient's quality of life.
Mood State (Scale 1–10): (1: Extreme Depression/Anxiety – 10: Balanced)
Sleep Quality: (Insomnia, apnea, restful sleep)
Energy Levels: _________________________________________________
Body Image: How does the patient feel regarding current physical changes?
Patient's Note: _________________________________________________
VI. Endocrinologist’s Observations
Treatment Response: (Full Remission / Partial Remission / Recurrence)
Action Plan: ____________________________________________________
Next Appointment: //____
Instructor's Guide for Students:
When using this record, remember that cortisol does not just alter sugar levels and blood pressure; it "dismantles" proteins in the muscles and skin. A patient reporting that they feel "less weak" when climbing stairs is often a clinical indicator as powerful as a drop in urinary cortisol levels.
