The diagnosis of Cushing's syndrome
The diagnosis of Cushing's syndrome
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DOI：
10.1007/s11154-010-9143-3
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发表时间：
2010-06-01
影响因子：
8.2
通讯作者：
Findling, James W.
中科院分区：
文献类型：
--
作者：
Carroll, Ty B.;Findling, James W.
自发性库欣综合征是一种众所周知但不常见的临床疾病。许多临床特征（中心体重增加、葡萄糖耐受不良、高血压、肌肉无力）在其他常见情况下也可见。对于有多种特征的患者、年龄异常的特征（如早发性骨质疏松症或高血压）、库欣综合征特异性特征（如易瘀伤、面部过多和紫纹）以及偶发肾上腺肿块或多囊卵巢综合征的患者，应提示评估皮质醇过量。深夜唾液皮质醇、1 mg地塞米松夜间抑制试验或24 h尿游离皮质醇测定具有很好的诊断特征，应在疑似库欣综合征的患者中进行。如果最初的检测结果不正常，则应由具有库欣综合征诊断和鉴别诊断经验的内分泌学家指导进一步评估。
Spontaneous Cushing's syndrome is well known but unusual clinical disorder. Many of the clinical features (central weight gain, glucose intolerance, hypertension, muscle weakness) are seen in other common conditions. Recognition of patients with multiple features, features unusual for their age (i.e. early onset osteoporosis or hypertension), patients with features more specific to Cushing's syndrome (i.e. easy bruising, facial plethora, and violaceous striae), and patients with incidental adrenal mass or polycystic ovary syndrome should prompt an evaluation for cortisol excess. Late-night salivary cortisol, 1 mg overnight dexamethasone suppression testing, or 24 h urine free cortisol determination have excellent diagnostic characteristics and should be obtain in patients with suspected Cushing' syndrome. If this initial testing is abnormal, further evaluation should be directed by an endocrinologist experienced in the diagnosis and differential diagnosis of Cushing' syndrome.