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. 2011 Oct;15 Suppl 4(Suppl4):S317-21.
doi: 10.4103/2230-8210.86974.

Cushing's syndrome: Stepwise approach to diagnosis

Anurag R Lila  1 , Vijaya Sarathi, Varsha S Jagtap, Tushar Bandgar, Padmavathy Menon, Nalini S Shah
Affiliations

Cushing's syndrome: Stepwise approach to diagnosis

Anurag R Lila et al. Indian J Endocrinol Metab. 2011 Oct.

Abstract

The projected prevalence of Cushing's syndrome (CS) inclusive of subclinical cases in the adult population ranges from 0.2-2% and it may no longer be considered as an orphan disease (2-3 cases/million/year). The recognition of CS by physicians is important for early diagnosis and treatment. Late-night salivary cortisol, dexamethasone suppressiontesti, or 24-h urine free cortisol are good screening tests. Positively screened cases need stepwise evaluation by an endocrinologist. This paper discusses the importance of screening for CS and suggests a stepwise diagnostic approach to a case of suspected hypercortisolism.

Keywords: Cushing's syndrome; dexamethasone suppression tests; hypercortisolism; salivary cortisol; urinary free cortisol.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Algorithm for evaluating patients suspected of having CS
See this image and copyright information in PMC

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