The four endocrine disorders selected for these test strategy paradigms are Cushing syndrome
, pheochromocytoma, primary aldosteronism, and hypercalcemia.
A low dose dexamethasone overnight suppression test was carried out in which the patient was administered 1 mg of dexamethasone i/v overnight and the result was serum cortisol 43.5 microgram/dl revealing suppression of the cortisol levels and suggesting that no endogenous abnormality of cortisol secretion by adrenal gland was present ruling out the adrenal cause of cushing syndrome
. ACTH levels were performed and the result was elevated serum ACTH levels 205pg/ml (ref: 0-46pg/ml).
Nested stromal epithelial tumor of liver presenting with Cushing syndrome
: a rare case report.
Patients with hirsutism due to etiologies other than PCOS like idiopathic hirsutism, Cushing syndrome
or late-onset congenital adrenal hyperplasia, pregnant or nursing women and those with any concomitant illnesses or immunosuppression were excluded.
Merke et al., "Altered amygdala and hippocampus function in adolescents with hypercortisolemia: a functional magnetic resonance imaging study of Cushing syndrome
," Development and Psychopathology, vol.
(16.) Messina MF, Valenzise M, Aversa S, Arrigo T, De Luca F Iatrogenic Cushing syndrome
caused by ocular glucocorticoids in a child.
Nieman, "Cortisolemic indices predict severe infections in cushing syndrome
due to ectopic production of adrenocorticotropin," Journal of Clinical Endocrinology and Metabolism, vol.
Table 2 Predictors of non-alcoholic fatty liver disease and metabolic syndrome in non-functioning adrenal adenoma and Cushing Syndrome
groups Beta OR P 95%CI Age -0.16 0.984 0.352 0.951-1.018 Model 1 Gender 0.307 1.359 0.519 0.535-3.541 NAFLD Hypercortisolism 1.246 3.476 0.021 1.204-10.036 Age 0.522 1.686 0.069 0.926-1.003 Model 2 Gender 0.269 1.309 0.604 0.473-3.621 NAFLD Hypercortisolism 0.522 1.686 0.373 0.535-5.319 Metabolic 2.215 9.162 <0.001 3.338-25.149 Syndrome Age 0.031 1.032 0.071 0.997-1.068 Model 3 Gender 0.255 1.290 0.603 0.494-3.370 Metabolic Hypercortisolism 2.358 10.571 0.004 2.162-51.688 Syndrome NAFLD, non-alcoholic hepatosteatosis, OR, odds ratio
Ritonavir-fluticasone interaction causing Cushing syndrome
in HIV-infected children and adolescents.
While adrenal carcinoma accounts for only approximately 5-10% of cases of Cushing syndrome
; approximately 40% of patients with both Cushing syndrome
and an adrenal mass have a malignant tumour (2, 3).