Clinical features with a high specificity for CS include facial plethora, spontaneous bruising, broad violaceous striae (>1 cm), unexplained osteoporosis, and proximal myopathy.40,41 On laboratory evaluation, these patients may exhibit hypokalaemia (mineralocorticoid receptor activation from cortisol excess), hyperglycemia (especially post-prandial hyperglycaemia),42 hyperandrogenism, secondary hyperparathyroidism, leucocytosis and raised liver enzymes. The gene discussed is NR3C2; the disease is Hyperglycemia.