Cushing syndrome: update on testing

• Published in: Endocrinology and Metabolism Clinics of North America
• Main Author: Raff, Hershel
• Format: Text
• Language: unknown
• Published: Advocate Aurora Health Institutional Repository 2015
• Subjects: Adrenal incidentalomas; Cushing disease; Inferior petrosal sinus sampling; Salivary cortisol; Advocate Aurora Research Institute; Aurora Research Institute
• Online Access: https://institutionalrepository.aah.org/endo/20; https://doi.org/10.1016/j.ecl.2014.10.005

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.