The superiority of the metyrapone test versus the high-dose dexamethasone test in the differential diagnosis of Cushing's syndrome

Sindler, Bruce H.; Griffing, George T.; Melby, James C.

doi:10.1016/0002-9343(83)91024-0

Cited by 28 publications

(3 citation statements)

References 15 publications

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“…administration (11). Some patients also had metyrapone suppression testing (12). Patients have been fol¬ lowed postoperatively for a mean of 22.3±3.08 (range 3-56) months.…”

Section: Methodsmentioning

confidence: 99%

A critical evaluation of transsphenoidal pituitary surgery in the treatment of Cushing's disease: Prediction of outcome

Arnott

Pestell

McKelvie

et al. 1990

Acta Endocrinologica

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Twenty-eight patients underwent transsphenoidal pituitary surgery for Cushing's disease. Selective surgical procedures were performed in 26. In 19 patients pituitary adenoma was confirmed histologically and 5 had clumps or clusters of ACTH-staining cells. At follow-up after 22.3 (range 5-56) months 21 (75%) patients remained in clinical and biochemical remission. The 24-h urinary free cortisol performed between 1 and 4 weeks postoperatively while patients took replacement doses of dexamethasone (0.5 to 0.75 mg per day) was found to predict outcome. All patients with suppressed urinary free cortisol excretion have remained in remission, 3 with levels in the normal range have suffered late relapse after initial remission, and 4 with elevated urinary free cortisol excretion were regarded as having failed to remit. Furthermore, all patients with unsuccessful outcomes had no pituitary adenoma and 3 had features consistent with cor-

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“…administration (11). Some patients also had metyrapone suppression testing (12). Patients have been fol¬ lowed postoperatively for a mean of 22.3±3.08 (range 3-56) months.…”

Section: Methodsmentioning

confidence: 99%

A critical evaluation of transsphenoidal pituitary surgery in the treatment of Cushing's disease: Prediction of outcome

Arnott

Pestell

McKelvie

et al. 1990

Acta Endocrinologica

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“…and normal suppression on the DST. The other 2 patients (subjects 3 and 4) showed subnormal cortexolone levels and DST non-suppression, a paradoxical response which may take place with adrenal tumors [Spiger et al, 1975;Sindler et al, 1983]. Subjects 2 and 3 had among the highest post-metyrapone cortisol levels in the schizo phrenic sample.…”

Section: Resultsmentioning

confidence: 94%

“…Plasma cortexolone concentrations in normal subjects increase from less than 1 pg/dl to 7-22 pg/dl at 08.00 h following a sin gle dose of metyrapone the preceding night [Spiger et al, 1975]. Sindler et al [1983] have provided more recent validation of this procedure. On metyrapone testing pa tients with adrenal insufficiency or adrenal tumors have subnormal cortexolone responses, whereas a high normal or exaggerated response is observed in patients with Cushing's syndrome caused by adrenal hyperplasia, in patients with untreated hypothyroidism or in women receiving oral contraceptives [Spiger et al, 1975],…”

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confidence: 99%

The Metyrapone Test in Schizophrenic Patients and Healthy Subjects

Morphy¹,

Fava²,

Carson³

et al. 1985

Neuropsychobiology

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The metyrapone test, a useful and reliable procedure for assessing hypothalamic-pituitary-adrenocortical (HPA) axis function, was applied to schizophrenic patients and healthy controls. 4 out of 18 patients had subnormal responses to metyrapone whereas there were no such cases in the 22 control subjects. 1 schizophrenic patient and 3 control subjects had high normal responses to metyrapone. The relationship with the dexamethasone suppression test was found to be complex. These preliminary results suggest that the HPA axis activity patterns in psychiatric illness may be more complicated than previously reported.

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Cushing's Syndrome Resulting From Primary Pigmented Nodular Adrenocortical Disease

Kaplowitz¹

1986

Arch Pediatr Adolesc Med

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The superiority of the metyrapone test versus the high-dose dexamethasone test in the differential diagnosis of Cushing's syndrome

Cited by 28 publications

References 15 publications

A critical evaluation of transsphenoidal pituitary surgery in the treatment of Cushing's disease: Prediction of outcome

A critical evaluation of transsphenoidal pituitary surgery in the treatment of Cushing's disease: Prediction of outcome

The Metyrapone Test in Schizophrenic Patients and Healthy Subjects

Cushing's Syndrome Resulting From Primary Pigmented Nodular Adrenocortical Disease

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