Cushing syndrome is the constellation of signs and symptoms caused by protracted 
exposure to glucocorticoids. The most common cause of Cushing syndrome in 
children and adolescents is exogenous administration of glucocorticoids. 
Presenting features commonly include weight gain, growth retardation, hirsutism, 
obesity, striae, acne and hypertension. Almost invariably, linear growth is 
severely diminished, a factor which may be useful in differentiating between 
childhood obesity and Cushing syndrome. Diagnostic approaches are based on 
distinguishing between adrenocorticotropic hormone (ACTH)-dependent and 
ACTH-independent etiologies, and consideration of the most likely diagnosis by 
age. Treatment modality is dependent upon etiology. After cure, important 
components of care include attention to linear growth, pubertal progression and 
body composition.