Abstract | OBJECTIVE: METHODS: In this retrospective study, we reviewed medical records of patients who underwent either the overnight 8-mg HDDS test or the 2-day 2-mg HDDS test every 6 hours. The percentage suppression of morning serum cortisol and the percentage suppression of 24-hour urine free cortisol (UFC) were calculated. RESULTS: Of 141 patients with proven CD who underwent HDDS tests, 77 (55%) underwent the overnight 8-mg HDDS test and 64 (45%) underwent the 2-day 2-mg HDDS test every 6 hours. With the overnight 8-mg HDDS test, 73 of 77 patients (95%) had greater than 50% suppression and 48 of 77 patients (62%) had greater than 80% suppression of the morning serum cortisol in comparison with the baseline value. With the 2-day 2-mg HDDS test, only 41 of 64 patients (64%) had greater than 90% suppression of 24-hour UFC. CONCLUSION: We conclude that the overnight 8-mg HDDS test accurately confirmed the diagnosis of CD with a high sensitivity of 95% with use of a criterion of greater than 50% suppression; in contrast, the sensitivity was only 62% with use of a more precise cutoff of greater than 80% suppression. The 2-day 2-mg HDDS test with a criterion of greater than 90% suppression of 24-hour UFC had a sensitivity of 64%. These results confirm the limited precision of the HDDS tests.
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Authors | Serhat Aytug, Edward R Laws Jr, Mary Lee Vance |
Journal | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
(Endocr Pract)
2012 Mar-Apr
Vol. 18
Issue 2
Pg. 152-7
ISSN: 1934-2403 [Electronic] United States |
PMID | 21856594
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
- Glucocorticoids
- Dexamethasone
- Hydrocortisone
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Topics |
- Adrenal Cortex
(drug effects, metabolism, physiopathology)
- Adult
- Cohort Studies
- Dexamethasone
(administration & dosage)
- Dose-Response Relationship, Drug
- Female
- Follow-Up Studies
- Glucocorticoids
(administration & dosage)
- Humans
- Hydrocortisone
(blood, metabolism, urine)
- Male
- Medical Records
- Middle Aged
- Pituitary ACTH Hypersecretion
(blood, diagnosis, physiopathology, urine)
- Retrospective Studies
- Sensitivity and Specificity
- Time Factors
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