2005
DOI: 10.1507/endocrj.52.463
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Discrepancies in Results of Low-and High-dose Dexamethasone Suppression Tests for Diagnosing Preclinical Cushing's Syndrome

Abstract: Abstract. According to the diagnostic criteria for adrenal preclinical Cushing's syndrome (PreCS) established by a group headed by the Ministry of Health, Labor and Welfare (MHLW), low-and high-dose dexamethasone suppression tests (DSTs) must be performed to prove autonomous cortisol secretion, i.e., ³3 mg/dL serum cortisol following 1-mg DST administration, and ³1 mg/dL serum cortisol following 8-mg DST administration. However, discrepancies have been documented in the results of low-and high-dose DSTs. We th… Show more

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Cited by 23 publications
(16 citation statements)
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“…According to the Japanese diagnostic criteria for SCS [24], the former was positive (>1 µg/dL) and the latter was negative (<3 µg/dL). A similar discrepancy is often seen in SCS patients [25]. Interestingly, urinary free cortisol levels paradoxically increase in response to dexamethasone treatment in a dose-dependent manner in some (4 of 9) patients with AIMAH [26].…”
Section: Discussionsupporting
confidence: 58%
“…According to the Japanese diagnostic criteria for SCS [24], the former was positive (>1 µg/dL) and the latter was negative (<3 µg/dL). A similar discrepancy is often seen in SCS patients [25]. Interestingly, urinary free cortisol levels paradoxically increase in response to dexamethasone treatment in a dose-dependent manner in some (4 of 9) patients with AIMAH [26].…”
Section: Discussionsupporting
confidence: 58%
“…5 DHEA-S level lower than the age-and sex-matched reference level. CS, Cushing's syndrome; DHEA-S, dehydroepiandrosterone sulfate; DST, dexamethasone suppression test; SCS, subclinical Cushing's syndrome; CRH, corticotropine-releasing hormone tension, IGT/DM, or hypercholesterolemia were also defined as having these diseases.…”
Section: Subjectsmentioning
confidence: 63%
“…The different sensitivity of assay kits for low serum cortisol levels, particularly in the range of 1-3 µg/dL sometimes results in false-positive or falsenegative diagnosis of SCS. Because cortisol levels ≥1 µg/dL after a high-dose, 8 mg, DST are required in the current diagnostic criteria for SCS, discrepancies in the results of DSTs, including suppression after a 1 mg DST but no suppression after a 8 mg DST have been reported [5]. One way to overcome this problem is to standardize cortisol levels among the many assay kits based on the determination of an absolute cortisol value measured by liquid chromatography/tandem mass spectrometry [6].…”
Section: Subjectsmentioning
confidence: 99%
“…Во избежание получения ложноположи-тельных результатов некоторые авторы предлагают использовать вместо 1 мг дек-саметазона 3 мг или даже 8 мг [3,7,50,51]. Однако это не получило всеобщего призна-ния, и при недавнем исследовании не полу-чено данных, свидетельствующих о преиму-ществах НПТ с 8 мг дексаметазона по сравне-нию с НПТ с 1 мг декcаметазона при выявле-нии субклинического гиперкортицизма [52].…”
Section: определение и патогенезunclassified