Endocrine Journal | |
Discrepancies in Results of Low-and High-dose Dexamethasone Suppression Tests for Diagnosing Preclinical Cushing's Syndrome | |
Nobuhiko SAITO1  Takuyuki KATABAMI1  Naoko SHIRAI1  Ryusei OBI1  Satoru NAITO1  | |
[1] Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine | |
关键词: Adrenal incidentaloma; Dexamethasone suppression test; Preclinical Cushing's syndrome; Diagnostic methods; | |
DOI : 10.1507/endocrj.52.463 | |
学科分类:内分泌与代谢学 | |
来源: Japan Endocrine Society | |
【 摘 要 】
References(14)Cited-By(8)According to the diagnostic criteria for adrenal preclinical Cushing's syndrome (PreCS) established by a group headed by the Ministry of Health, Labor and Welfare (MHLW), low- and high-dose dexamethasone suppression tests (DSTs) must be performed to prove autonomous cortisol secretion, i.e., ≥3 μg/dL serum cortisol following 1-mg DST administration, and ≥1 μg/dL serum cortisol following 8-mg DST administration. However, discrepancies have been documented in the results of low-and high-dose DSTs. We therefore investigated the validity of the DST for diagnosing PreCS by performing 1-mg and 8-mg DSTs in 39 patients with adrenal incidentaloma, but no characteristic Cushingoid symptoms. In about half of these patients (20/39, 51.3%), high-dose DST was positive but low-dose was negative, and one or more of the other abnormalities of hypothalamus-pituitary-adrenal axis dysfunction was seen in 75% of these patients. Furthermore, no significant difference in incidence of glucose intolerance and hypertension was noted in patients with positive high-dose DST and negative low-dose DST compared with patients with positive low- and high-dose DST. Under the current MHLW diagnostic criteria, patients with positive high-dose DST and negative low-dose DST are not diagnosed with PreCS, but some of these patients should be. Discrepancies in the results of low- and high-dose DSTs appear attributable to the current cutoff values, and further investigations are necessary to resolve these discrepancies.
【 授权许可】
Unknown
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