A single sleeping midnight cortisol has 100% sensitivity for the diagnosis of Cushing's syndrome

摘要: OBJECTIVE The diagnosis of Cushing's syndrome remains a major challenge in clinical endocrinology. Various screening tests are commonly used to support biochemical the context suspicion. aim this study was compare sensitivity single in-patient sleeping midnight cortisol standard 48-hour low-dose dexamethasone suppression test (LDDST) during same admission. DESIGN A retrospective analysis performed on 150 patients investigated our department between years 1970 and 1994 with confirmed syndrome. PATIENTS One hundred fifty were analysed : 110 disease ; 12 tumours ectopic ACTH secretion 8 dependent so far undetermined origin 17 secreting adrenal 3 adrenocortical nodular hyperplasia. Twenty normal volunteers nine non-endocrine conditions also as controls. MEASUREMENTS Plasma measured by radioimmunoassay (RIA) 122 presenting after 1980, fluorimetry prior date. RESULTS In all control subjects < 50 nmol/l, below lowest routine in-house RIA. every patient detectable value greater than range 70-2000 nmol/l. contrast, three cases, whom had proven histology, there uncharacteristic complete plasma nmol/l following LDDST. CONCLUSION series above 100% for syndrome, clearly different from subjects. 98% even when drug administered an in-patient. We recommend that should not be alone confirmation since it may miss 2% cases.