Dexamethasone Infusion Test for Diagnosis of Cushing Disease ...

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Cushing's disease patients diagnosed with dexamethasone infusion test from 2004 to 2013 of the diagnostic protocol were reviewed. Biemond diagnosis criteria ...
LBS  –  083   Dexamethasone   Infusion   Test   for   Diagnosis   of   Cushing   Disease   ACTH   Dependent   and   Their   Rela:on   with   Tumoral   Size,   Experience   Ins:tuto  Nacional  De  Neurología  Y  Neurocirugía  Manuel  Velasco  Suárez.   Portocarrero-­‐Or2z  Lesly.,  Terrones-­‐Lozano  Alejandro.,  Or2z-­‐Reyes  Ricardo  A.,  MarAnez  Jazmín.   Ins2tuto  Nacional  de  Neurología  y  Neurocirugía  Manuel  Velasco  Suárez.,  México,  D.F.   The  authors  declare  that  there  is  no  conflct  of  interest. Background

Cortisol Suppression by Meassure and Relation with Tumor Size

- Diagnosis age mean: 38.7 yrs (14-68).

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Diagnosis ACTH Dependent Cushing’s Disease and Gender Distribution

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All records of ACTH dependent Cushing’s disease patients diagnosed with dexamethasone infusion test from 2004 to 2013 of the diagnostic protocol were reviewed. Biemond diagnosis criteria was used for the procedure and interpretation, results were compared with tumoral size. Tumoral size evaluated with magnetic resonance image. MRI was classificated as: - Microadenoma < 10mm, - Macroadenoma >10mm, and - Giant adenoma >40 mm.

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Microadenoma

Macroadenoma

Giant Tumor

Dexamethasone Infusion Test Other Diagnosis Test

Tumor Size Classification

5.9%

Cortisol Absolute Difference Suppression and Relation with Tumor Size 2

16.7%

35.3% 58.8%

Microadenoma Macroadenoma Giant Tumor

Suppression ≥ 50% Suppression < 50%

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83.3%

Man Female Materials and Methods

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To describe the experience of dexamethasone infusion test for ACTH dependent Cushing’s syndrome diagnosis in association with tumoral size.

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Objectives

Cortisol Suppression by Percentage and Relation with Tumor Size

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Dexamethasone infusion test has a sensibility between 95-100% and specificity between 70-90% for Cushing’s syndrome diagnosis.

Results

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83.3%

0 Microadenoma

Macroadenoma

Giant Tumor

Conclussions The level of suppression based on both criteria may suggest the presence of a microadenoma or macroadenoma. In cases where suppression was at least 50%, it suggests a microadenoma or macroadenoma. When cortisol levels are indeterminate on the second day of the test, it could relate to a microadenoma and when they are higher than 10 µg/dL to a macroadenoma. References and Contact Information Peter Biemond et al., Annals of internal medicine , 1990;112:738-742.

Suppression < 6.8 µg/dL Suppression ≥ 6.8 mg/dL

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Macroadenoma Giant Tumor

Dra. Lesly Portocarrero-Ortiz - Email: [email protected] - Telephone: +52(55)5606 3822 Ext. 2066 - Mailing: Avenida Insurgentes Sur 3877, La Fama, Tlalpan, 14269. Ciudad de México, D.F., México.