A single midnight serum cortisol measurement distinguishes Cushing's syndrome from pseudo-Cushing states

The Journal of Clinical Endocrinology and Metabolism
D A PapanicolaouL K Nieman

Abstract

Cushing's syndrome (CS) may be difficult to distinguish from pseudo-Cushing states (PCS) based on physical findings or urinary glucocorticoid excretion. As the lack of diurnal variation in serum cortisol is characteristic of CS, we studied whether diurnal cortisol determinations could discriminate CS from PCS. Two hundred and sixty-three patients were evaluated: 240 had CS, and 23 had PCS. Urine was collected for 24 h for measurement of cortisol and 17-hydroxycorticosteroids (17OHCS). Blood was drawn at 2300, 2330, 0000, 0030, and 0100 h and at 0600, 0630, 0700, 0730, and 0800 h the next morning for serum cortisol determination. The main outcome measure was the sensitivity of these parameters for the diagnosis of CS at 100% specificity. A midnight cortisol value greater than 7.5 microg/dL correctly identified 225 of 234 patients with CS and all PCS patients. This sensitivity (96%) was superior to that obtained for any other measure, including urinary cortisol (45%), 17OHCS (22%), any other individual cortisol time point (10-92%), the morning (23%) or the evening (93%) cortisol mean, and the ratio (11%) of morning to evening values. We conclude that at 100% specificity, a single serum cortisol value above 7.5 microg/dL at midnig...Continue Reading

Citations

Sep 27, 2008·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·M E PallT C Friedman
Feb 8, 2005·BMJ : British Medical Journal·Ronald C W MaChun Chung Chow
Dec 4, 2008·American Journal of Physiology. Endocrinology and Metabolism·Jonathan Q PurnellJohn D Brunzell
Jul 3, 2009·Neuroimmunomodulation·George P ChrousosEvangelia Charmandari
Mar 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Lynnette K NiemanVictor M Montori
Jun 24, 2006·Journal of Endocrinological Investigation·S TsagarakisN Thalassinos
Oct 26, 2002·Journal of Endocrinological Investigation·J M CunninghamR E Weiss
Sep 8, 2010·Reviews in Endocrine & Metabolic Disorders·Ty B Carroll, James W Findling
Nov 2, 2006·Pituitary·Martina De MartinFrancesco Cavagnini
Nov 24, 2007·Pituitary·Blerina Kola, Ashley B Grossman
Sep 29, 2006·Expert Review of Anticancer Therapy·Rebecca L Brown, Roy E Weiss
Sep 21, 2010·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Simon V LiubinasAndrew H Kaye
Mar 19, 2014·Frontiers in Neuroendocrinology·Leonidas Panagiotakopoulos, Gretchen N Neigh
Dec 28, 2005·The American Journal of Medicine·Lynnette K Nieman, Ioannis Ilias
Sep 6, 2005·Urology·Darlene D Lin, Kevin R Loughlin
Apr 29, 2015·Journal of Endocrinological Investigation·F Pecori Giraldi
Mar 7, 2020·The Journal of Clinical Endocrinology and Metabolism·Brandon P GalmNicholas A Tritos
Jul 16, 2009·The Journal of Clinical Endocrinology and Metabolism·Hershel Raff
Sep 13, 2003·The Journal of Clinical Endocrinology and Metabolism·Pietro PutignanoFrancesco Cavagnini
Mar 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Mohamed B ElaminVictor M Montori
Jul 27, 2006·The Journal of Clinical Endocrinology and Metabolism·James W Findling, Hershel Raff
Aug 26, 1998·The Journal of Clinical Endocrinology and Metabolism·H RaffJ W Findling
Nov 4, 2000·The Journal of Clinical Endocrinology and Metabolism·M MoroF Cavagnini
Jan 14, 2018·European Journal of Endocrinology·Natasha IronsidePrashant Chittiboina
Feb 15, 2017·Endocrine·Aaron HodesMihail Zilbermint

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Journal of Clinical Endocrinology and Metabolism
A R GlassM Schaaf
Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association
T C Friedman
The Journal of Clinical Endocrinology and Metabolism
M A MagiakouG P Chrousos
© 2022 Meta ULC. All rights reserved