Discrepancies in Results of Low-and High-dose Dexamethasone Suppression Tests for Diagnosing Preclinical Cushing's Syndrome

摘要: According to the diagnostic criteria for adrenal preclinical Cushing's syndrome (PreCS) established by a group headed Ministry of Health, Labor and Welfare (MHLW), low- high-dose dexamethasone suppression tests (DSTs) must be performed prove autonomous cortisol secretion, i.e., > or =3 microg/dL serum following 1-mg DST administration, =1 8-mg administration. However, discrepancies have been documented in results low-and DSTs. We therefore investigated validity diagnosing PreCS performing DSTs 39 patients with incidentaloma, but no characteristic Cushingoid symptoms. In about half these (20/39, 51.3%), was positive low-dose negative, one more other abnormalities hypothalamus-pituitary-adrenal axis dysfunction seen 75% patients. Furthermore, significant difference incidence glucose intolerance hypertension noted negative compared DST. Under current MHLW criteria, are not diagnosed PreCS, some should be. Discrepancies appear attributable cutoff values, further investigations necessary resolve discrepancies.