Severe obesity confounds the interpretation of low-dose dexamethasone test combined with the administration of ovine corticotrophin-releasing hormone in childhood Cushing syndrome.

The Journal of Clinical Endocrinology and Metabolism
Dalia L BatistaConstantine A Stratakis

Abstract

Suppression of cortisol secretion with a low-dose dexamethasone (Dex) followed by the administration of ovine CRH (Dex-oCRH) is used in the evaluation of adults with a pseudo-Cushing syndrome state (PCSS) vs. Cushing syndrome (CS). The aim of the study was to determine the value of Dex-oCRH testing in the investigation of childhood CS. We conducted a retrospective analysis of data from children evaluated for CS vs. PCSS from 1998-2006; body mass index Z (BMIZ) and height-for-age Z (HAZ) scores were estimated. A clinical research center was the setting for the study. The main outcomes were confirmation of the diagnosis of CS by histology and response to Dex-oCRH. Thirty-two children (ages 3-17 yr) were studied: 11 had CS and 21 had PCSS; of the latter, 11 had a BMIZ score greater than 2. Children with CS had a mean HAZ score of -1.3+/-0.51 vs. 0.31+/-0.38 in nonobese and 0.71+/-0.39 in obese children (P<0.001). The previously established criterion of a cortisol of 1.4 microg/dl (38 nmol/liter) after Dex-oCRH identified all 10 normal children who were not very obese and those with CS; 5 of 11 normal children with more severe obesity had cortisol values greater than 1.4 microg/dl (38 nmol/liter) after Dex-oCRH, lowering the test s...Continue Reading

References

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Aug 19, 2007·Pediatrics·Dalia L BatistaConstantine A Stratakis

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Citations

May 28, 2009·The Journal of Clinical Endocrinology and Metabolism·Dalia L BatistaConstantine A Stratakis
Sep 1, 2009·Journal of Clinical Research in Pediatric Endocrinology·John W Honour
Oct 27, 2012·Endocrinology and Metabolism Clinics of North America·Constantine A Stratakis
Aug 19, 2015·Obesity Research & Clinical Practice·Leonard SaieghCarmela Shechner
Jun 1, 2016·Endocrinology and Metabolism Clinics of North America·Constantine A Stratakis
Jun 27, 2019·JIMD Reports·Margaret A StefaterJoseph A Majzoub
Dec 8, 2010·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Nalini S ShahPadmavathy Menon

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