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.
TYRRELL JB, FINDLING JW, ARON DC, FITZGERALD PA, FORSHAM PH. 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.
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.
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Adrenal Disorders, Endocrine and Metabolism.
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