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Nonsuppressible Oral Dexamethasone Suppression Tests but Not Cushing Syndrome
- Source :
- Case Reports in Endocrinology, Case Reports in Endocrinology, Vol 2016 (2016)
- Publication Year :
- 2015
-
Abstract
- In spite of the presence of definitive diagnostic criteria to diagnose Cushing syndrome diagnosis may become challenging. We report a young female with mild clinical features of Cushing syndrome, who had nonsuppressible oral dexamethasone suppression tests; also she had a suspicious pituitary lesion. She underwent pituitary surgery and a pituitary microadenoma (non-ACTH staining) was removed. Now she had come to us with similar complaints to those before. Again she had nonsuppressible oral dexamethasone suppression tests. As the diurnal variation of serum and salivary cortisol was maintained and urinary free cortisol was normal, further evaluation with IV dexamethasone suppression test was performed which clearly ruled out Cushing syndrome. The patient was not on any medicines known to alter dexamethasone metabolism. Fat malabsorption was also ruled out using appropriate tests. The reason for this discrepancy is thought to be altered (increased) metabolism of dexamethasone in this patient as it is widely variable in the general population.
- Subjects :
- medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Population
030209 endocrinology & metabolism
Case Report
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Gastroenterology
Oral dexamethasone
Lesion
03 medical and health sciences
Cushing syndrome
0302 clinical medicine
030225 pediatrics
Internal medicine
medicine
education
Dexamethasone
education.field_of_study
lcsh:RC648-665
Suppression tests
business.industry
medicine.disease
Fat malabsorption
Endocrinology
Dexamethasone suppression test
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 20906501
- Volume :
- 2016
- Database :
- OpenAIRE
- Journal :
- Case reports in endocrinology
- Accession number :
- edsair.doi.dedup.....0ee405efbd8304ea95b41b42f6d0b324