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Updated: Mar 19, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

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Published on: April 25, 2016

Investigation for Paediatric Cushing's Syndrome Using Twenty-Four-Hour Urinary Free Cortisol Determination.

Lucy Shapiro¹, Shezan Elahi, Fiona Riddoch

¹Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Hormone Research in Paediatrics

|June 12, 2016

Summary

Diagnosing paediatric Cushing's syndrome (CS) is challenging. A 24-hour urinary free cortisol (UFC) test is a reliable and accurate method for diagnosing CS in children.

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Published on: March 1, 2018

Area of Science:

Pediatric Endocrinology
Endocrine Diagnostics
Biochemical Analysis

Background:

Paediatric Cushing's syndrome (CS) presents diagnostic challenges.
Accurate diagnostic tools are crucial for timely intervention in children.

Purpose of the Study:

To evaluate the diagnostic accuracy of 24-hour urinary free cortisol (UFC) in children with suspected CS.
To determine the reliability of UFC as a primary diagnostic test for paediatric CS.

Main Methods:

Retrospective analysis of 66 paediatric patients with suspected CS (1982-2014).
Analysis of 24-hour UFC collections using radioimmunoassay, chemiluminescent immunoassay, or LC-MS/MS.
Statistical evaluation including ROC analysis and t-tests, with data normalized for body surface area.

Main Results:

The 24-hour UFC test demonstrated excellent diagnostic accuracy for paediatric CS (AUC 0.98).
Sensitivity was 89% and specificity was 100% for the UFC test.
The test proved highly effective in differentiating CS from control cases.

Conclusions:

24-hour UFC is a highly accurate and practical test for diagnosing paediatric CS.
While reliable, further investigations may be warranted if UFC results are normal despite high clinical suspicion.
UFC determination is a valuable tool in the paediatric endocrinology armamentarium.