High prevalence of normal tests assessing hypercortisolism in subjects with mild and episodic Cushing's syndrome suggests that the paradigm for diagnosis and exclusion of Cushing's syndrome requires multiple testing.

摘要: Many Endocrinologists believe that a single determination of eucortisolism or demonstration appropriate suppression to dexamethasone excluded Cushing's syndrome, except in what was previously thought be the rare patient with episodic periodic syndrome. We hypothesize syndrome is relatively common and test assessing hypercortisolism may not sufficient accurately rule out diagnose retrospectively examined number normal abnormal tests performed on multiple occasions 66 patients found have mild and/or compared similar group 54 evaluated for, but determined 65 had at least one cortisol status most several tests. The probability having when negative 92% for 23:00 h salivary cortisol, 88% 24-h UFC, 86% 17OHS, 54% nighttime plasma cortisol. These results demonstrated highly prevalent subjects no effective conclusively diagnosing excluding condition. Rather, paradigm diagnosis should careful history physical examination those whom syndrome/disease strongly suspected, subsequent occasions, especially experiencing signs symptoms short-term hypercortisolism.