An overnight high-dose dexamethasone suppression test for rapid differential diagnosis of Cushing's syndrome. Ann Intern Med 1986 Feb;104(2):180-6
Date
02/01/1986Pubmed ID
3004275DOI
10.7326/0003-4819-104-2-180Scopus ID
2-s2.0-0022636443 (requires institutional sign-in at Scopus site) 135 CitationsAbstract
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 adrenocorticotrophic 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 17-hydroxycorticosteroids 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.
Author List
Tyrrell JB, Findling JW, Aron DC, Fitzgerald PA, Forsham PHAuthor
James W. Findling MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
17-HydroxycorticosteroidsACTH Syndrome, Ectopic
Adenoma
Adolescent
Adrenal Gland Neoplasms
Adrenocorticotropic Hormone
Adult
Aged
Carcinoma
Child
Cushing Syndrome
Depression, Chemical
Dexamethasone
Diagnosis, Differential
Drug Administration Schedule
Evaluation Studies as Topic
Female
Humans
Hydrocortisone
Male
Middle Aged
