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endocrine society guidelines for Cushing

Ernest Yorke, Yacoba Atiase, Josephine Akpalu, Osei Sarfo-Kantanka
Cushing's syndrome is a rare entity, and a high index of suspicion is needed for screening in a primary care setting. The clinical awareness of the primary care physician (PCP) to the highly indicative signs and symptoms such as facial plethora, proximal myopathy, reddish purple striae, and easy bruisability should alert him to look for biochemical evidence of Cushing's syndrome through any of the first-line screening tests, namely, 24-hour urinary free cortisol, overnight dexamethasone suppression test, or late-night salivary cortisol...
2017: International Journal of Endocrinology
Joseph M Pappachan, Christian Hariman, Mahamood Edavalath, Julian Waldron, Fahmy W Hanna
Diagnosis of Cushing's syndrome (CS) and identification of the aetiology of hypercortisolism can be challenging. The Endocrine Society clinical practice guidelines recommends one of the four tests for initial screening of CS, namely, urinary-free cortisol, late night salivary cortisol, overnight dexamethasone suppression test or a longer low-dose dexamethasone suppression test, for 48 hours. Confirmation and localisation of CS requires additional biochemical and radiological tests. Radiological evaluation involves different imaging modalities including MRI with or without different radio-nuclear imaging techniques...
April 2017: Journal of Clinical Pathology
Filippo Ceccato, Marco Boscaro
Endogenous Cushing's syndrome (CS) is a rare disease, and usually characterized by hypertension, diabetes, obesity, osteoporosis, facial rounding, dorsocervical fat pad, thin skin, purple striae, hirsutism, and mood disorders. Efficient diagnostic and screening strategies lead to the diagnosis of a significantly higher number of cases of CS. As a screening test for CS, the Endocrine Society's Clinical Practice Guidelines recommend a single test with a high diagnostic accuracy, among the 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and 24 h urinary free cortisol (UFC)...
September 2016: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Filippo Ceccato, Mattia Barbot, Marialuisa Zilio, Anna Chiara Frigo, Nora Albiger, Valentina Camozzi, Giorgia Antonelli, Mario Plebani, Franco Mantero, Marco Boscaro, Carla Scaroni
INTRODUCTION AND AIM: As initial screening for Cushing's syndrome (CS), The Endocrine Society guidelines recommend one of the following: the 1-mg dexamethasone suppression test (DST) or late-night salivary cortisol (LNSC) or urinary free cortisol (UFC) measurement. We examined the diagnostic performance of the above-mentioned tests in a series of patients. MATERIALS AND METHODS: We retrospectively analyzed 137 patients with clinical conditions suggestive of hypercortisolism: 38 with confirmed CS diagnosis and 99 without (termed non-CS)...
October 2015: Journal of Clinical Endocrinology and Metabolism
Lynnette K Nieman, Beverly M K Biller, James W Findling, M Hassan Murad, John Newell-Price, Martin O Savage, Antoine Tabarin
OBJECTIVE: The objective is to formulate clinical practice guidelines for treating Cushing's syndrome. PARTICIPANTS: Participants include an Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. The European Society for Endocrinology co-sponsored the guideline. EVIDENCE: The Task Force used the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence...
August 2015: Journal of Clinical Endocrinology and Metabolism
Filippo Ceccato, Giorgia Antonelli, Mattia Barbot, Marialuisa Zilio, Linda Mazzai, Rosalba Gatti, Martina Zaninotto, Franco Mantero, Marco Boscaro, Mario Plebani, Carla Scaroni
OBJECTIVE: The Endocrine Society Clinical Guidelines recommend measuring 24-h urinary free cortisol (UFF) levels using a highly accurate method as one of the first-line screening tests for the diagnosis of Cushing's Syndrome (CS). We evaluated the performance of UFF, urinary free cortisone (UFE), and the UFF:UFE ratio, measured using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. SUBJECTS AND METHODS: The LC-MS/MS was used to analyze UFF and UFE levels in 43 surgically confirmed CS patients: 26 with Cushing's disease (CD, 16 de novo and ten recurrences), 11 with adrenal CS and six with ectopic CS; 22 CD patients in remission; 14 eu-cortisolemic CD patients receiving medical therapy; 60 non-CS patients; and 70 healthy controls...
July 2014: European Journal of Endocrinology
Deborah Anne Gust, Thomas P Gordon
We present a case of late diagnosis of an adolescent female with Cushing's disease or excess glucocorticoid secretion due to the presence of an adrenocorticotropic hormone (ACTH) secreting tumor on the pituitary. Her main complaints at first presentation in 2008 were short stature and weight gain. Although these are the main criteria for testing for Cushing's syndrome outlined by the 2008 Endocrine Society guidelines, they were not enough to lead to a timely diagnosis. The reasons may include the endocrinologists believing that additional more common symptoms needed to be present to test for Cushing's syndrome...
2013: Journal of Pediatric Endocrinology & Metabolism: JPEM
Yuko Akehi, Hisaya Kawate, Kunitaka Murase, Ryoko Nagaishi, Takashi Nomiyama, Masatoshi Nomura, Ryoichi Takayanagi, Toshihiko Yanase
Subclinical Cushing's syndrome (SCS) associated with adrenal incidentaloma is usually characterized by autonomous cortisol secretion without overt symptoms of Cushing's syndrome (CS). Although the diagnostic criteria for SCS differ among countries, the 1 mg dexamethasone suppression test (DST) is essential to confirm the presence and the extent of cortisol overproduction. Since 1995, SCS has been diagnosed in Japan based on serum cortisol levels ≥3 μg/dL (measured by radioimmunoassay [RIA]) after a 1 mg DST...
2013: Endocrine Journal
Phyllis W Speiser, Ricardo Azziz, Laurence S Baskin, Lucia Ghizzoni, Terry W Hensle, Deborah P Merke, Heino F L Meyer-Bahlburg, Walter L Miller, Victor M Montori, Sharon E Oberfield, Martin Ritzen, Perrin C White
OBJECTIVE: We developed clinical practice guidelines for congenital adrenal hyperplasia (CAH). PARTICIPANTS: The Task Force included a chair, selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), ten additional clinicians experienced in treating CAH, a methodologist, and a medical writer. Additional experts were also consulted. The authors received no corporate funding or remuneration. CONSENSUS PROCESS: Consensus was guided by systematic reviews of evidence and discussions...
September 2010: Journal of Clinical Endocrinology and Metabolism
Laurence Guignat, Jérôme Bertherat
Cushing's syndrome is considered a rare disease and its diagnosis can be challenging. Establishment of evidence-based recommendations is difficult. In 2008, several national and international consensus recommendations for the diagnosis or management of Cushing's syndrome were reported. The Endocrine Society, with the participation of the European Society of Endocrinology, has developed a task force to update recommendations for the diagnosis of Cushing's syndrome. The main aspects of these recommendations are presented in this article and discussed in the context of current research efforts in Europe focusing on the improvement of diagnosis and management of rare diseases including adrenal disorders such as Cushing's syndrome...
July 2010: European Journal of Endocrinology
Lynnette K Nieman, Beverly M K Biller, James W Findling, John Newell-Price, Martin O Savage, Paul M Stewart, Victor M Montori
OBJECTIVE: The objective of the study was to develop clinical practice guidelines for the diagnosis of Cushing's syndrome. PARTICIPANTS: The Task Force included a chair, selected by the Clinical Guidelines Subcommittee (CGS) of The Endocrine Society, five additional experts, a methodologist, and a medical writer. The Task Force received no corporate funding or remuneration. CONSENSUS PROCESS: Consensus was guided by systematic reviews of evidence and discussions...
May 2008: Journal of Clinical Endocrinology and Metabolism
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