The Diagnosis and Differential Diagnosis of Cushing’s Syndrome and Pseudo-Cushing’s States
Abstract
I. Introduction II. Definitions and Etiology III. Diagnostic Overview IV. Clinical Features V. Biochemical Diagnosis of Cushing’s Syndrome A. Cardinal features B. Urinary free cortisol (UFC) C. Low-dose dexamethasone testing D. Circadian rhythm assessment E. Cyclical Cushing’s syndrome VI. ACTH-Dependent vs. ACTH-Independent Cushing’s Syndrome VII. Differential Diagnosis of ACTH-Dependent Cushing’s Syndrome A. Overview B. Basal testing C. Dynamic noninvasive testing D. Invasive testing VIII. Other Causes of Cushing’s Syndrome IX. Imaging A. Pituitary B. Adrenal C. Ectopic secretion X. Differentiation from Pseudo-Cushing’s States XI. Conclusions
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Use of a serum cortisol endpoint in the LDDST is simpler and has higher diagnostic accuracy.
“Use of a serum cortisol end point is simpler and has higher diagnostic accuracy (78).”
From The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. (2008) · cites this paper as [78]
In endogenous Cushing's syndrome of any cause, there is a failure of suppression when low doses of dexamethasone are given.
“In endogenous Cushing's syndrome of any cause, there is a failure of this suppression when low doses of the synthetic glucocorticoid dexamethasone are given (78).”
From The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. (2008) · cites this paper as [78]
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- Authors
- Newell-Price, J., Trainer, P., Besser, M., & Grossman, A.
- Affiliations
- St Bartholomew's Hospital (GB)
- Venue
- Endocrine Reviews
- Publisher
- The Endocrine Society
- Published
- 1998-10-01
- Volume
- 19
- Issue
- 5
- Pages
- 647-672
- ISSN
- 0163-769X (ISSN-L)
- 1945-7189
- OpenAlex
- W2011381127
- Cited by
- 833
- References
- 10
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 17 · 2023: 13 · 2022: 23 · 2021: 18 · 2020: 21 · 2019: 20 · 2018: 35 · 2017: 30 · 2016: 30 · 2015: 38 · 2014: 41 · 2013: 26 · 2012: 33
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Keywords
- Cushing's syndrome, differential diagnosis, ACTH-dependent Cushing's syndrome, ACTH-independent Cushing's syndrome, urinary free cortisol, low-dose dexamethasone suppression test, ectopic ACTH syndrome, pituitary imaging, adrenal imaging, biochemical diagnosis
- MeSH terms
- ACTH Syndrome, Ectopic, Adrenocorticotropic Hormone, Anti-Inflammatory Agents, Circadian Rhythm, Corticotropin-Releasing Hormone, Cushing Syndrome, Deamino Arginine Vasopressin, Dexamethasone, Diagnosis, Differential, Female, Growth Substances, Humans, Hydrocortisone, Magnetic Resonance Imaging, Male, Metyrapone, Oligopeptides, Renal Agents, Tomography, X-Ray Computed, Vasopressins, Petrosal Sinus Sampling
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