PROS AND CONS OF DEXAMETHASONE SUPPRESSION TEST FOR SCREENING OF SUBCLINICAL CUSHING'S SYNDROME IN PATIENTS WITH ADRENAL INCIDENTALOMAS.
Summary of "PROS AND CONS OF DEXAMETHASONE SUPPRESSION TEST FOR SCREENING OF SUBCLINICAL CUSHING'S SYNDROME IN PATIENTS WITH ADRENAL INCIDENTALOMAS."
The results of dexamethasone suppression tests (DST) in the screening of subclinical hypercortisolism are not readily comparable. Aim of the present study was to review the effectiveness of the overnight 1-mg DST and 8-mg DST to look for functional autonomy of clinically inapparent adrenal adenomas. Sixty-eight consecutive patients with clinically inapparent adrenal adenomas were enrolled. All patients underwent 1-mg DST. The 8-mg DST was performed in the 11 patients who had post 1-mg DST cortisol >138 nmol/L and in 11 patients who had post 1-mg DST cortisol between 50 - 138 nmol/L. The a priori probability to have autonomous cortisol secretion was defined by the presence of at least two alterations of the HPA axis among reduced ACTH concentrations, elevated UFC or elevated midnight serum cortisol. Cortisol levels > 138 nmol/L after the 1-mg DST increases the posttest probability of adrenal functional autonomy to 55%, whereas cortisol levels <50 nmol/L reduce the post-test probability to 8%. Cortisol levels recorded after the 8-mg DST were non-significantly lower than after the 1-mg DST and all the patients with cortisol >138 nmol/L after the 1 mg DST maintained cortisol above this cut-point. The 1-mg DST should be considered as the more effective test to detect autonomous cortisol secretion by a clinically inapparent adrenal adenoma when cortisol levels are >138 nmol/l, while cortisol levels < 50 nmol/L reduces remarkably the post-test probability of this event. The 8-mg DST seems to replicate by large the results of the 1-mg DST.
Affiliation
Internal Medicine I, Department of Clinical and Biological Sciences, AOU San Luigi Gonzaga, University of Turin, Turin, Italy. giuseppe.reimondo@unito.it.
Journal Details
This article was published in the following journal.
Name: Journal of endocrinological investigation
ISSN: 1720-8386
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20634637
- DOI: http://dx.doi.org/10.3275/7167
Medical and Biotech [MESH] Definitions
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