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DIAGNOSIS & DIFFERENTIAL DIAGNOSIS OF CUSHING'S


Guest arlene

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This one is NOT in medline. Let me know if you would like a copy of this study. SNAILMAIL or fax only (message me) - for personal use only as it is copywrighted material.

 

Endocrinology and Metabolism Clinics

Volume 30 ? Number 3 ? September 2001

Copyright ? 2001 W. B. Saunders Company

 

 

NEUROENDOCRINOLOGY

 

-------------------------------------------------------------------

DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF CUSHING'S SYNDROME

 

James W. Findling 1 3 MD

Hershel Raff 2 3 PhD

 

1 Endocrine-Diabetes Center (JWF)

2 Endocrine Research Laboratory (HR), St. Luke's Medical Center

3 Medical College of Wisconsin, Milwaukee, Wisconsin (JWF, HR)

 

--------------------------------------------------------------------------------

Address reprint requests to

Hershel Raff, PhD

Department of Endocrinology

St. Luke's Physician's Office Building, Suite 245

2801 W KK River Parkway

Milwaukee, WI 53215

e-mail: hraff@mcw.edu

 

Here is the Summary....

 

"In the early part of the twentieth century, two clinical syndromes were described--one in Europe (metabolic syndrome X)[2] and one in the United States (Cushing's syndrome)[16] --that were as clinically indistinguishable then as they are now at the beginning of the twenty-first century. Metabolic syndrome X has emerged as one of the most important public health problems in the United States, whereas Cushing's syndrome has become the most challenging diagnostic problem in clinical endocrinology.[26] The differentiation of patients with true spontaneous Cushing's syndrome from the large number of patients with the Cushing's phenotype can be clinically difficult, especially when the degree of hypercortisolism is mild.[14] [40] [63] The recognition of subclinical hypercortisolism in some patients with incidentally discovered adrenocortical tumors and the clinical improvement observed in these patients following adrenalectomy illustrate the importance of discovering even mild Cushing's syndrome.[63] Several comprehensive reviews of this topic have been published recently.[26] [48] [50] This article highlights the liabilities of the traditional diagnostic approach to Cushing's syndrome and reviews some of the new diagnostic studies that are available that can aid endocrinologists in the diagnosis and differential diagnosis of this disorder."

 

Here is the outline...if the topics interest you...message me....

 

 

 

 CLINICAL FEATURES

 

 BIOCHEMICAL DIAGNOSIS

 

 Urine Free Cortisol

 

 Low-Dose Dexamethasone Suppression Testing

 

 Late-Night Serum and Salivary Cortisol

 

 Dexamethasone-Corticotropin-Releasing Hormone

 

 Desmopressin Stimulation Test

 

 Iatrogenic Cushing's Syndrome Owing to Inhaled/Nasal Corticosteroids

 

 DIFFERENTIAL DIAGNOSIS

 

 Plasma Corticotropin

 

 High-Dose Dexamethasone Suppression Testing

 

 Inferior Petrosal Sinus Sampling

 

 Pituitary Magnetic Resonance Imaging

 

 SUMMARY

 

 References

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Kristy, i would love a copy of this article as they may help me so much...I have been trying to get a definite diagnosis for some time now and these topics are of great interest to me. Would you be so kind as to email them to me? My email address is...arlene@netvision.net.il....thanks so much Kristy an dhope you are doing well..arlene

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