{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:47:48Z","timestamp":1791870468537,"version":"4.3.4"},"reference-count":20,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 37-year-old woman presented with severe hypertension, mood changes, and weight loss (body mass index 14.6\u2005kg\/m2). She exhibited restrictive eating behaviors consistent with anorexia nervosa, alongside biochemical hypercortisolemia with serum cortisol 43.6\u2005\u00b5g\/dL (1204\u2005nmol\/L; reference range: 6.2-18.1\u2005\u00b5g\/dL; 170-500\u2005nmol\/L), 24-hour urinary free cortisol 430.3\u2005\u00b5g\/24\u2005hours (1187\u2005nmol\/24\u2005hours; reference range: &amp;lt;60.2\u2005\u00b5g\/24\u2005hours; &amp;lt;166\u2005nmol\/24\u2005hours), and unsuppressed adrenocorticotropic hormone of 19.1\u2005pg\/mL (4.2\u2005pmol\/L; reference range: 7.3-63.1\u2005pg\/mL; 1.6-13.9\u2005pmol\/L). The cortisol level after the 1\u2005mg dexamethasone suppression test was 23.9\u2005\u00b5g\/dL (659\u2005nmol\/L; reference range: &amp;lt;1.8\u2005\u00b5g\/dL; &amp;lt;50\u2005nmol\/L). Cortisol remained markedly elevated after nasogastric feeding and weight restoration. Pituitary magnetic resonance imaging revealed a 4\u2005mm left anterior pituitary lesion. High-dose dexamethasone suppression, corticotropin-releasing hormone stimulation, and inferior petrosal sinus sampling confirmed a pituitary source of adrenocorticotropic hormone. The patient underwent transsphenoidal resection of a corticotroph adenoma. Eleven months later, her hypertension and restrictive eating behaviors had resolved, and her mood significantly improved. Cushing syndrome can coexist with anorexia nervosa, masking typical cushingoid features and presenting with psychiatric manifestations and weight loss. Persistent hypercortisolemia despite nutritional rehabilitation should prompt dynamic endocrine testing and pituitary evaluation to ensure timely diagnosis and treatment.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag309","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:11:54Z","timestamp":1790334714000},"source":"Crossref","is-referenced-by-count":0,"title":["When anorexia nervosa conceals Cushing syndrome: a diagnostic pitfall in hypercortisolemia"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5585-4011","authenticated-orcid":false,"given":"Miao Yunn","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Endocrinology, The Prince of Wales Hospital , Randwick, NSW 2031 ,","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of New South Wales , Randwick, NSW 2031 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