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Related Experiment Videos

Diagnostic tests for Cushing's syndrome differ from published guidelines: data from ERCUSYN.

Elena Valassi1, Holger Franz2, Thierry Brue3

  • 1IIB-Sant Pau and Department of Endocrinology/MedicineHospital Sant Pau, UAB, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain.

European Journal of Endocrinology
|April 6, 2017
PubMed

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Summary

Diagnostic test usage for Cushing's syndrome (CS) varies across Europe, with some methods differing from current guidelines. A European consensus is needed to standardize the diagnostic approach for CS, considering regional availability of tests.

Area of Science:

  • Endocrinology
  • Clinical Diagnostics

Background:

  • Cushing's syndrome (CS) diagnosis relies on various biochemical tests.
  • Current guidelines exist, but real-world test utilization may vary.

Purpose of the Study:

  • To evaluate the diagnostic tests used for CS in the European Registry on Cushing's syndrome (ERCUSYN).
  • To assess if the utilization of these tests aligns with current clinical guidelines.

Main Methods:

  • Analysis of data from 1341 CS patients in the ERCUSYN database (2000-2016).
  • Categorization of CS subtypes: pituitary-dependent (PIT-CS), adrenal-dependent (ADR-CS), ectopic (ECT-CS), and other (OTH-CS).
  • Examination of the frequency and trends in the use of first-line and additional diagnostic tests.

Main Results:

Related Experiment Videos

  • Urinary free cortisol (UFC), overnight dexamethasone suppression test (DST), and late-night salivary cortisol (LSaC) were common first-line tests.
  • Late-night serum cortisol (LSeC) and ACTH measurement were frequently performed.
  • LSaC use increased over time; LSeC and overnight DST showed higher diagnostic support for PIT-CS and ADR-CS compared to UFC.

Conclusions:

  • Significant variation exists in CS diagnostic test usage across European centers.
  • Current practices partly deviate from established guidelines.
  • A European consensus is recommended to optimize CS diagnosis, accounting for inter-country differences in test availability.