Objective: To evaluate which tests are performed to diagnose hypercortisolism in patients included in the European Registry on Cushing's syndrome (ERCUSYN), and to examine if their use differs from the current guidelines. Patients and methods: We analyzed data on the diagnostic tests performed in 1341 patients with Cushing's syndrome (CS) who have been entered into the ERCUSYN database between January 1, 2000 and January 31, 2016 from 57 centers in 26 European countries. Sixty-seven percent had pituitary-dependent CS (PIT-CS), 24% had adrenaldependent CS (ADR-CS), 6% had CS from an ectopic source (ECT-CS) and 3% were classified as having CS from other causes (OTH-CS). Results: Of the first-line tests, urinary free cortisol (UFC) test was performed in 78% of patients, overnight 1 mg dexamethasone suppression test (DST) in 60% and late-night salivary cortisol (LSaC) in 25%. Use of LSaC increased in the last five years as compared with previous years (P < 0.01). Use of HDDST was slightly more frequent in the last 5 years as compared with previous years (P < 0.05). Of the additional tests, late-night serum cortisol (LSeC) was measured in 62% and 48-h 2 mg/day low-dose dexamethasone suppression test (LDDST) in 33% of cases. ACTH was performed in 78% of patients. LSeC and overnight 1 mg DST supported the diagnosis of both PIT-CS and ADR-CS more frequently than UFC (P < 0.05).

Diagnostic tests for Cushing's syndrome differ from published guidelines : Data from ERCUSYN / E. Valassi, H. Franz, T. Brue, R.A. Feelders, R. Netea-maier, S. Tsagarakis, S.M. Webb, M. Yaneva, M. Reincke, M. Droste, I. Komerdus, D. Maiter, D. Kastelan, P. Chanson, M. Pfeifer, C.J. Strasburger, M. Tã³th, O. Chabre, A. Tabarin, M. Krsek, C. Fajardo, M. Bolanowski, A. Santos, J.A..H. Wass, P.J. Trainer, A.G. Ambrogio, G. Aranda, M. Arosio, M. Balomenaki, P. Beck-peccoz, C. Berr-kirmair, J. Bollerslev, D. Carvalho, F. Cavagnini, E. Christ, F. Demtrã¶der, J. Denes, C. Dimopoulou, A. Dreval, T. Dusek, E. Erdinc, J..A. Evang, J. Fazel, S. Fica, E. Ghigo, M. Goth, Y. Greenman, V. Greisa, I. Halperin, F..A. Hanzu, A. Hermus, G. Johannsson, P. Kamenicky, A. Kasperlik-zaluska, J. Kirchner, I. Kraljevic, A. Kruszynska, I. Lambrescu, S. Lang, A. Luger, N. Marpole, S. Martin, M. Martinie, O. Moros, J. Newell-price, M. Orbetzova, I. Paiva, F. PECORI GIRALDI, A..M. Pereira, J. Pickel, V. Pirags, O. Ragnarsson, A..D. Reghina, P. Riesgo, M. Roberts, S. Roerink, O. Roig, C. Rowan, P. Rudenko, M..A. Sahnoun, J. Salvador, H..A. Sigurjonsdottir, T..S. Polovina, R. Smith, B. Stachowska, G. Stalla, J. Tã³ke, E. Ubina, S. Vinay, M. Wagenmakers, S. Werner, J. Young, P. Zdunowski, K. Zopf, S. Zopp, I. Zosin. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 0804-4643. - 176:5(2017 May), pp. 613-624. [10.1530/EJE-16-0967]

Diagnostic tests for Cushing's syndrome differ from published guidelines : Data from ERCUSYN

A.G. Ambrogio;M. Arosio;F. PECORI GIRALDI;
2017-05

Abstract

Objective: To evaluate which tests are performed to diagnose hypercortisolism in patients included in the European Registry on Cushing's syndrome (ERCUSYN), and to examine if their use differs from the current guidelines. Patients and methods: We analyzed data on the diagnostic tests performed in 1341 patients with Cushing's syndrome (CS) who have been entered into the ERCUSYN database between January 1, 2000 and January 31, 2016 from 57 centers in 26 European countries. Sixty-seven percent had pituitary-dependent CS (PIT-CS), 24% had adrenaldependent CS (ADR-CS), 6% had CS from an ectopic source (ECT-CS) and 3% were classified as having CS from other causes (OTH-CS). Results: Of the first-line tests, urinary free cortisol (UFC) test was performed in 78% of patients, overnight 1 mg dexamethasone suppression test (DST) in 60% and late-night salivary cortisol (LSaC) in 25%. Use of LSaC increased in the last five years as compared with previous years (P < 0.01). Use of HDDST was slightly more frequent in the last 5 years as compared with previous years (P < 0.05). Of the additional tests, late-night serum cortisol (LSeC) was measured in 62% and 48-h 2 mg/day low-dose dexamethasone suppression test (LDDST) in 33% of cases. ACTH was performed in 78% of patients. LSeC and overnight 1 mg DST supported the diagnosis of both PIT-CS and ADR-CS more frequently than UFC (P < 0.05).
adrenocorticotropic hormone; adult; aged; cushing syndrome; diagnostic tests, routine; europe; female; humans; hydrocortisone; male; middle aged; practice guidelines as topic; statistics as topic; registries; endocrinology, diabetes and metabolism; endocrinology
Settore MED/13 - Endocrinologia
Article (author)
File in questo prodotto:
File Dimensione Formato  
EJE Valassi 2017.pdf

non disponibili

Tipologia: Publisher's version/PDF
Dimensione 1.32 MB
Formato Adobe PDF
1.32 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/530615
Citazioni
  • ???jsp.display-item.citation.pmc??? 10
  • Scopus 29
  • ???jsp.display-item.citation.isi??? 30
social impact