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Cushing syndrome: update on testing.

Hershel Raff1

  • 1Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Endocrine Research Laboratory, Aurora St. Luke's Medical Center, Aurora Research Institute, 2801 West KK River Parkway, Suite 245, Milwaukee, WI 53215, USA.

Endocrinology and Metabolism Clinics of North America
|March 4, 2015
PubMed
Summary
This summary is machine-generated.

Diagnosing Cushing syndrome involves assessing late-night salivary cortisol and using prolactin measurements during inferior petrosal sinus sampling for accurate differential diagnosis of ACTH-dependent cases.

Keywords:
Adrenal incidentalomasCushing diseaseInferior petrosal sinus samplingSalivary cortisol

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Area of Science:

  • Endocrinology
  • Clinical Medicine
  • Diagnostic Laboratory Evaluation

Background:

  • Cushing syndrome, or endogenous hypercortisolism, presents complex diagnostic challenges in clinical medicine.
  • Accurate laboratory evaluation is crucial for diagnosing and differentiating subtypes of Cushing syndrome.
  • Adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome requires careful distinction between Cushing disease and ectopic ACTH syndrome.

Purpose of the Study:

  • To provide an updated review on critical aspects of diagnosing and differentiating Cushing syndrome.
  • To highlight the utility of late-night salivary cortisol in initial diagnosis and postoperative monitoring.
  • To evaluate the role of prolactin measurement in enhancing inferior petrosal sinus sampling for differential diagnosis.

Main Methods:

  • Review of current literature on diagnostic methods for Cushing syndrome.
  • Analysis of the application of late-night salivary cortisol assays.
  • Assessment of the combined use of inferior petrosal sinus sampling and prolactin measurements.

Main Results:

  • Late-night salivary cortisol is a valuable tool for initial Cushing syndrome diagnosis and postoperative surveillance.
  • Prolactin measurement improves the diagnostic performance of inferior petrosal sinus sampling.
  • These methods aid in distinguishing Cushing disease from ectopic ACTH syndrome in ACTH-dependent cases.

Conclusions:

  • Updated diagnostic strategies enhance the accuracy of Cushing syndrome evaluation.
  • Late-night salivary cortisol and prolactin-assisted inferior petrosal sinus sampling are key advancements.
  • Improved diagnostic accuracy facilitates timely and appropriate patient management for Cushing syndrome.