Cushing Syndrome : Update on Testing - 01/03/15

Doi : 10.1016/j.ecl.2014.10.005

Hershel Raff, PhD ^a,^b,^c,^d,^⁎
^a Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
^b Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
^c Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
^d Endocrine Research Laboratory, Aurora St. Luke’s Medical Center, Aurora Research Institute, 2801 West KK River Parkway, Suite 245, Milwaukee, WI 53215, USA

^∗Endocrinology, Aurora St. Luke’s Medical Center, 2801 West KK River Parkway, Suite 245, Milwaukee, WI 53215.

Resumen

Endogenous hypercortisolism (Cushing syndrome) is one of the most enigmatic diseases in clinical medicine. The diagnosis and differential diagnosis of Cushing syndrome depend on proper laboratory evaluation. In this review, an update is provided on selected critical issues in the diagnosis and differential diagnosis of Cushing syndrome: the use of late-night salivary cortisol in initial diagnosis and for postoperative surveillance, and the use of prolactin measurement to improve the performance of inferior petrosal sinus sampling to distinguish Cushing disease from ectopic adrenocorticotropic hormone (ACTH) syndrome during differential diagnosis of ACTH-dependent Cushing syndrome.

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Keywords : Cushing disease, Salivary cortisol, Inferior petrosal sinus sampling, Adrenal incidentalomas