Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

36
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the...
36
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

24
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
24
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

3.7K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
3.7K
Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

5.9K
Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
5.9K

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Evaluation of differences in presentation and postoperative outcomes after adrenalectomy for pheochromocytoma according to age.

Endocrine connections·2026
Same author

Primary pancreatic paraganglioma: a systematic review.

Endocrine·2026
Same author

Selective Inhibition of Insulin-Degrading Enzyme Eliminates Hemolysis Interference in Serum Insulin Measurements.

Diagnostics (Basel, Switzerland)·2026
Same author

Approach to the patient: Precision Medicine-Guided Evaluation and Treatment of Acromegaly.

The Journal of clinical endocrinology and metabolism·2026
Same author

Common errors in the initial management of hyponatremia.

Endocrinologia, diabetes y nutricion·2026
Same author

Primary hepatic gastrinoma as a clinical mimic: Favorable clinical outcomes.

Endocrinologia, diabetes y nutricion·2026

Related Experiment Video

Updated: May 2, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

Published on: April 25, 2016

9.1K

Urinary Free Cortisol-Based Thresholds for Differentiating ACTH-Dependent Cushing's: A Spanish Validation Study.

Betina Biagetti1, Pedro Marques2, Alfonso Soto-Moreno3

  • 1Endocrinology & Nutrition Department. Hospital Universitario Vall d'Hebrón and Vall d'Hebron Research Institute (VHIR), Department of Medicine, Autonomous University of Barcelona, Reference Networks (ERN), 08035. Barcelona, Spain.

The Journal of Clinical Endocrinology and Metabolism
|May 1, 2026
PubMed
Summary

Urinary free cortisol (UFC) and salivary cortisol (LNSC) effectively distinguish ectopic ACTH secretion (EAS) from Cushing's disease (CD). High cortisol levels and hypokalemia strongly predict EAS, guiding diagnostic imaging strategies.

Keywords:
Cushing’s DiseaseCushing’s SyndromeEctopic CushingHypercortisolismUrinary Free Cortisol

More Related Videos

Extraction and Analysis of Cortisol from Human and Monkey Hair
08:38

Extraction and Analysis of Cortisol from Human and Monkey Hair

Published on: January 24, 2014

28.4K
A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

26.6K

Related Experiment Videos

Last Updated: May 2, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

Published on: April 25, 2016

9.1K
Extraction and Analysis of Cortisol from Human and Monkey Hair
08:38

Extraction and Analysis of Cortisol from Human and Monkey Hair

Published on: January 24, 2014

28.4K
A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

26.6K

Area of Science:

  • Endocrinology
  • Diagnostic Medicine
  • Clinical Research

Background:

  • Distinguishing ectopic ACTH secretion (EAS) from Cushing's disease (CD) is a diagnostic challenge in ACTH-dependent Cushing's syndrome.
  • Urinary free cortisol (UFC) normalized to upper limits of normal (ULN) has shown potential as a discriminator, but requires external validation.

Purpose of the Study:

  • To validate the diagnostic performance of UFC×ULN for differentiating EAS from CD.
  • To evaluate complementary markers like late-night salivary cortisol (LNSC×ULN) and hypokalemia.

Main Methods:

  • A multicenter retrospective study involving 269 patients with ACTH-dependent Cushing's syndrome from the Spanish Cushing Registry.
  • Assessed the diagnostic accuracy (AUC, sensitivity, specificity) of UFC×ULN and LNSC×ULN in distinguishing EAS from CD.

Main Results:

  • EAS patients were older and exhibited significantly higher UFC×ULN and LNSC×ULN compared to CD patients.
  • Both UFC×ULN and LNSC×ULN demonstrated excellent discriminative performance (AUC 0.90 and 0.92, respectively).
  • Severe hypercortisolism (UFC ≥ 10×ULN and LNSC ≥ 9×ULN) combined with hypokalemia identified 75% of EAS cases with 98% specificity.

Conclusions:

  • UFC×ULN thresholds reliably stratify the likelihood of EAS versus CD.
  • Severe hypercortisolism and hypokalemia are strong predictors of EAS, informing a pragmatic diagnostic approach.
  • This supports prioritizing whole-body imaging for high-risk patients and pituitary evaluation for milder cases.