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Screening Test for Cushing's Syndrome With Plasma 11-Hydroxycorticosteroids FREE

John F. Seidensticker, MD; Robert L. Folk, MD; Ralph G. Wieland, MD; GeorgeJ. Hamwi, MD
[+] Author Affiliations

Reprint requests to 410 W Tenth Ave, Columbus, Ohio 43210 (Dr. Seidensticker).

Dr. Hamwi died Feb 14, 1967.


JAMA. 1967;202(2):87-90. doi:10.1001/jama.1967.03130150055006
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In a rapid screening test for Cushing's syndrome, plasma cortisol was measured by a simple fluorometric method. We have verified the value of the overnight suppression test as a screening test for hyperadrenocorticism. An 8 AM plasma cortisol level of less than 10μg/ 100 ml after a single dose of 1 mg of dexamethasone was given orally the previous night at 11 PM essentially rules out Cushing's syndrome. Emotional or psychiatric disorders and acute illnesses may result in incomplete suppression. Oral contraceptive agents do not ordinarily result in a false-positive test. Patients who do not respond normally to overnight suppression with dexamethasone warrant further study.

REFERENCES

Nugent, C.A.; Nichols, T.; and Tyler, F.H.:  Diagnosis of Cushing's Syndrome , Arch Intern Med 116:172-176 ( (Aug) ) 1965;.
Pavlatos, F.C.; Smilo, R.P.; and Forsham, P.H.:  A Rapid Screening Test for Cushing's Syndrome , JAMA 193:720-723 ( (Aug 30) ) 1965;.
Mattingly, D.:  A Simple Fluorometric Method for the Estimation of Free 11-Hydroxycorticoids in Human Plasma , J Clin Path 15:374-479 ( (July) ) 1962;.
Gantt, C.L.; Maynard, D.E.; and Hamwi, G.J.:  Experience With a Simple Procedure for the Determination of Plasma and Urine Free 11-Hydroxycorticosteroids , Metabolism 13:1327-1332 ( (Nov) ) 1964;.
Nichols, C.T., and Nugent, C.A.:  Steroid Tests in the Diagnosis of Cushing's Syndrome , abstracted, Clin Res 15:125 ( (Jan) ) 1967;.
Bayliss, R.I.:  Factors Influencing Adrenocortical Activity in Health and Disease , Brit Med J 1:495-591 ( (Feb 26) ) 1955;.
Liddle, G.W.:  Tests of Pituitary-Adrenal Suppressibility in the Diagnosis of Cushing's Syndrome , J Clin Endocr 20:1539-1560 ( (Dec) ) 1960;.
Summers, V.K., et al:  Differential Diagnosis of Cushing's Syndrome and Obesity Associated With Striae , Lancet 2:1079-1082 ( (Nov 21) ) 1964;.
Stokes, P.E.: " Pituitary Suppression in Psychiatric Patients ," abstracted. Endocrine Society Program of the 48th Annual Meeting, 1966 , p 101.
Tucci, J.R., et al:  Rapid Dexamethasone Suppression Test for Cushing's Syndrome , JAMA 199:129-132 ( (Feb 6) ) 1967;.
Cope, C.L.:  The Adrenal Cortex in Internal Medicine: Part 1 , Brit Med J 2:847-853 ( (Oct) ) 1966;.
Maynard, D.E., et al:  A Rapid Test for Adrenocortical Insufficiency , Ann Intern Med 64:552-556 ( (March) ) 1966;.

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Nugent, C.A.; Nichols, T.; and Tyler, F.H.:  Diagnosis of Cushing's Syndrome , Arch Intern Med 116:172-176 ( (Aug) ) 1965;.
Pavlatos, F.C.; Smilo, R.P.; and Forsham, P.H.:  A Rapid Screening Test for Cushing's Syndrome , JAMA 193:720-723 ( (Aug 30) ) 1965;.
Mattingly, D.:  A Simple Fluorometric Method for the Estimation of Free 11-Hydroxycorticoids in Human Plasma , J Clin Path 15:374-479 ( (July) ) 1962;.
Gantt, C.L.; Maynard, D.E.; and Hamwi, G.J.:  Experience With a Simple Procedure for the Determination of Plasma and Urine Free 11-Hydroxycorticosteroids , Metabolism 13:1327-1332 ( (Nov) ) 1964;.
Nichols, C.T., and Nugent, C.A.:  Steroid Tests in the Diagnosis of Cushing's Syndrome , abstracted, Clin Res 15:125 ( (Jan) ) 1967;.
Bayliss, R.I.:  Factors Influencing Adrenocortical Activity in Health and Disease , Brit Med J 1:495-591 ( (Feb 26) ) 1955;.
Liddle, G.W.:  Tests of Pituitary-Adrenal Suppressibility in the Diagnosis of Cushing's Syndrome , J Clin Endocr 20:1539-1560 ( (Dec) ) 1960;.
Summers, V.K., et al:  Differential Diagnosis of Cushing's Syndrome and Obesity Associated With Striae , Lancet 2:1079-1082 ( (Nov 21) ) 1964;.
Stokes, P.E.: " Pituitary Suppression in Psychiatric Patients ," abstracted. Endocrine Society Program of the 48th Annual Meeting, 1966 , p 101.
Tucci, J.R., et al:  Rapid Dexamethasone Suppression Test for Cushing's Syndrome , JAMA 199:129-132 ( (Feb 6) ) 1967;.
Cope, C.L.:  The Adrenal Cortex in Internal Medicine: Part 1 , Brit Med J 2:847-853 ( (Oct) ) 1966;.
Maynard, D.E., et al:  A Rapid Test for Adrenocortical Insufficiency , Ann Intern Med 64:552-556 ( (March) ) 1966;.
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