J. BLAKE TYRRELL, M.D.; JAMES W. FINDLING, M.D.; DAVID C. ARON, M.D.; PAUL A. FITZGERALD, M.D.; PETER H. FORSHAM, M.D.
We have developed a high-dose dexamethasone suppression test that can be administered overnight with a single 8-mg dose and used the new procedure in the differential diagnosis of 83 patients with Cushing's syndrome. In 76 patients with surgically or pathologically proven cause—60 with Cushing's disease, 7 with the ectopic adrenocorticotropic hormone syndrome, and 9 with adrenal tumors—suppression of plasma Cortisol levels to less than 50% of baseline indicated a diagnosis of Cushing's disease. The test had a sensitivity of 92%, a specificity of 100%, and a diagnostic accuracy of 93%. These values equal or exceed those of the standard 2-day test whether based on suppression of urinary 17hydroxycorticosteroids or plasma Cortisol. We conclude that this overnight, high-dose dexamethasone suppression test is practical and reliable in the differential diagnosis of Cushing's syndrome.
J. BLAKE TYRRELL, JAMES W. FINDLING, DAVID C. ARON, PAUL A. FITZGERALD, PETER H. FORSHAM. An Overnight High-Dose Dexamethasone Suppression Test for Rapid Differential Diagnosis of Cushing's Syndrome. Ann Intern Med. 1986;104:180–186. doi: 10.7326/0003-4819-104-2-180
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Published: Ann Intern Med. 1986;104(2):180-186.
Adrenal Disorders, Endocrine and Metabolism.
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