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%
4
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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16.7%
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Dexamethasone infusion test has a sensibility between 95-100% and specificity between 70-90% for Cushing’s syndrome diagnosis.
Results
1
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
0
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.
