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Endocrinology

Screening for Cushing’s syndrome

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Pathogenesis
-Exogenous Cushing’s syndrome: corticosteroids administration
-Endogenous Cushing’s syndrome: autonomous cortisol overproduction

First-line screening tests for endogenous Cushing’s syndrome
– 1-mg dexamethasone suppression test
-24-hour urinary free cortisol excretion
-Late-night salivary cortisol measurement

* Scalp-hair cortisol/cortisone analysis may be beneficial to assess for long-term glucocorticoid exposure and detect transient periods of hypercortisolism

Further assessment to determine the cause of Cushing’s syndrome
-Imaging modalities
-Dynamic biochemical testing

Reference
Savas M, Mehta S, Agrawal N, et al. Approach to the patient: Diagnosis of Cushing’s syndrome. J Clin Endocrinol Metab. 2022;dgac492. doi: 10.1210/clinem/dgac492. Epub ahead of print. PMID: 36036941.

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