You suspect Cushing's disease in a 50-year-old woman who has glycosuria, hypertension, and a suggestive body habitus. Which finding would be against the diagnosis of Cushing's disease?

In the context of Cushing's disease, which is characterized by overproduction of cortisol, understanding the implications of specific findings is crucial to confirm or rule out the diagnosis.

A normal 8 AM cortisol level would typically argue against the diagnosis because in Cushing's disease, one would expect elevated cortisol levels, particularly in the morning due to disrupted diurnal variation. Therefore, the presence of a normal 8 AM cortisol level suggests that cortisol production is within normal limits.

Failure to suppress morning cortisol with dexamethasone is a typical finding in Cushing's disease, supporting the diagnosis as patients are often unable to suppress cortisol production due to the underlying pathology.

Hypertension requiring more than two antihypertensive agents can be consistent with Cushing's disease, as hypertension is a common symptom due to the effects of cortisol on blood pressure regulation.

The presence of unilateral adrenal enlargement is more indicative of an adrenal tumor or adrenal cause of hypercortisolism, rather than Cushing's disease, which is usually a result of pituitary adenomas causing bilateral adrenal hyperplasia. Cushing's disease typically involves stimulation of both adrenal glands, leading them to be enlarged rather than having one adrenal gland enlarged compared to the other. Thus, finding unilateral adrenal