The discriminatory value of the low-dose dexamethasone suppression test in the investigation of paediatric Cushing's syndrome

Hormone Research
R DiasM O Savage

Abstract

Low- and high-dose dexamethasone suppression tests (LDDST, HDDST) are used in the investigation of Cushing's syndrome (CS). In adults with Cushing's disease (CD), cortisol suppression during LDDST predicts suppression during the HDDST. We reviewed the results of the LDDST (0.5 mg 6 hourly x 48 h), HDDST (2.0 mg 6 hourly x 48 h) and corticotrophin-releasing hormone (CRH) test in 32 paediatric patients with CS: 24 had CD, 1 ectopic ACTH syndrome, 5 nodular adrenal hyperplasia and 2 adrenocortical tumours. In CD, LDDST suppressed cortisol from 590.7 +/- 168.8 (mean +/- SD) to 333.7 +/- 104.0 nmol/l after 48 h (0 vs. 48 h, p < 0.05; mean suppression, 45.1%; CI (30.8, 59.4%); 16/24 (66%) suppressed >30%; mean suppression 68.1%, CI (58.1, 77.9%)). The HDDST suppressed cortisol from 596.3 +/- 174.5 to 47.1 +/- 94.8 nmol/l after 48 h (0 vs. 48 h, p < 0.05; mean suppression, 93.5%; CI (88.2, 98.8%) with 17/24 (71%) suppressing to <50 nmol/l and 100% to <50% of baseline). In the LDDST, suppression correlated with that during the HDDST (r = +0.45, p < 0.05) with >30% suppression predicting that in the HDDST and hence CD. CRH increased cortisol by +100.3% (CI 62, 138.5%), 22/24 (91.7%) showing a >20% increase. In the other CS pathologies (...Continue Reading

References

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Jan 10, 2003·The Journal of Clinical Endocrinology and Metabolism·Helen L StorrMartin O Savage
Nov 7, 2003·The Journal of Clinical Endocrinology and Metabolism·Andrea M IsidoriAshley B Grossman
Jun 9, 2005·European Journal of Endocrinology·Helen L StorrMartin O Savage
Aug 1, 1996·Trends in Endocrinology and Metabolism : TEM·M O Savage, G M Besser

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Citations

Jun 16, 2007·Pituitary·Martin O SavageAshley B Grossman
Nov 24, 2007·Pituitary·Blerina Kola, Ashley B Grossman
Nov 28, 2007·Nature Clinical Practice. Endocrinology & Metabolism·Martin O Savage
Jun 13, 2009·Current Opinion in Pediatrics·Megan Moriarty, Francis Hoe
May 28, 2008·Hormone Research·Martin O SavageHelen L Storr
May 14, 2016·European Journal of Pediatrics·Maria GüemesMehul T Dattani
Jul 3, 2008·Current Opinion in Endocrinology, Diabetes, and Obesity·Martin O SavageHelen L Storr
Jan 31, 2021·Reviews in Endocrine & Metabolic Disorders·Rosario FerrignoMartin O Savage
Apr 7, 2007·Trends in Endocrinology and Metabolism : TEM·Helen L StorrMartin O Savage

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