ROBERT P. CASTELLUCCI, M.D.; JAMES K. SCHMITT, M.D.
To the editor: A recent report has noted that a high-dose (8 mg) overnight dexamethasone suppression test is helpful in separating patients with hypercortisolism due to Cushing's disease from those with adrenocortical tumors or ectopic adrenocorticotropic hormone secretion (1). It is well known that stress may result in serum Cortisol levels that are not suppressible by overnight testing with 1 mg of dexamethasone (2). The effect of high-dose overnight dexamethasone in stressed patients, however, has not been described.
We recently saw a 65-year-old man who 1 month previously had had a right hemicolectomy and subsequent chemotherapy with fluorouracil for a
CASTELLUCCI RP, SCHMITT JK. High-Dose Overnight Dexamethasone Testing and Intercurrent Illness. Ann Intern Med. ;106:332. doi: 10.7326/0003-4819-106-2-332_1
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Published: Ann Intern Med. 1987;106(2):332.
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