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Cited by 85Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

Recent Updates on the Diagnosis and Management of Cushing's Syndrome

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Nieman, Lynnette K.·2018·Endocrinology and Metabolism
DOI 10.3803/enm.2018.33.2.139PMC PMC6021313
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Abstract

Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to identify the condition at an early stage, as it tends to progress, accruing additional morbidity and increasing mortality rates. Once a clinical suspicion is raised, screening tests involve timed measurement of urine, serum or salivary cortisol at baseline or after administration of dexamethasone, 1 mg. Each test has caveats, so that the choice of tests must be individualized for each patient. Once the diagnosis is established, and the cause is determined, surgical resection of abnormal tumor/tissue is the optimal treatment. When this cannot be achieved, medical treatment (or bilateral adrenalectomy) must be used to normalize cortisol production. Recent updates in screening for and treating Cushing's syndrome are reviewed here.

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  • Other clinical findings and biochemical tests, including dexamethasone suppression test, are needed to provide confirmation of Cushing disease.

    “other clinical findings and biochemical tests, including DST, are needed to provide confirmation of CD [18, 24, 45, 87]”

    From Prospective Evaluation of Late-Night Salivary Cortisol and Cortisone by EIA and LC-MS/MS in Suspected Cushing Syndrome (2020) · cites this paper as [18]

    The Introduction says clinical features and biochemical testing are used to establish Cushing’s syndrome, and the Screening tests section includes DST. The Causes of Cushing’s syndrome section says determining a pituitary cause requires further evaluation, which may include 8 mg dexamethasone suppression. The source does not say DST is required to confirm Cushing’s disease specifically. (LLM, conf=0.85)

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Research works printed but not linked: 1

  1. [40]van der Pas R Leebeek FW Hofland LJ de Herder WW Feelders RA Hypercoagulability in Cushing's syndrome: prevalence, pathogenesis and treatment Clin Endocrinol (Oxf) 2013 78 481 488 23134530

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Authors
Nieman, L. K.
Affiliations
National Institutes of Health (US)
Corresponding author
Nieman, Lynnette K.
ORCID
Nieman, Lynnette K.
Venue
Endocrinology and Metabolism
Publisher
Korean Endocrine Society
Published
2018
Volume
33
Issue
2
Pages
139
ISSN
  • 2093-596X (ISSN-L)
  • 2093-5978
DOI
10.3803/enm.2018.33.2.139
PMC
PMC6021313
OpenAlex
W2811065941
Cited by
85
References
42
Citations by year
2026: 6 · 2025: 5 · 2024: 4 · 2023: 9 · 2022: 18 · 2021: 17 · 2020: 13 · 2019: 12 · 2018: 1
FWCI
1.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Endocrinology and Metabolism (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
National Institutes of Health
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
Cushing's syndrome, hypercortisolism, diagnosis, screening test, dexamethasone suppression test, salivary cortisol, urine cortisol, bilateral adrenalectomy, surgical resection, medical treatment, pituitary adenoma, adrenal tumors

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