Diagnostic tests for Cushing's syndrome differ from published guidelines: Data from ERCUSYN

Elena Valassi, Holger Franz, Thierry Brue, Richard A. Feelders, Romana Netea-Maier, Stylianos Tsagarakis, Susan M. Webb, Maria Yaneva, Martin Reincke, Michael Droste, Irina Komerdus, Dominique Maiter, Darko Kastelan, Philippe Chanson, Marija Pfeifer, Christian J. Strasburger, Miklós Tóth, Olivier Chabre, Antoine Tabarin, Michal KrsekCarmen Fajardo, Marek Bolanowski, Alicia Santos, John A.H. Wass, Peter J. Trainer, A. Ambrogio, G. Aranda, M. Arosio, M. Balomenaki, P. Beck-Peccoz, C. Berr-Kirmair, J. Bollerslev, D. Carvalho, F. Cavagnini, E. Christ, F. Demtröder, J. Denes, C. Dimopoulou, A. Dreval, T. Dusek, E. Erdinc, J. A. Evang, J. Fazel, S. Fica, E. Ghigo, M. Goth, Y. Greenman, V. Greisa, I. Halperin, F. A. Hanzu, A. Hermus, G. Johannsson, P. Kamenicky, A. Kasperlik-Zaluska, J. Kirchner, I. Kraljevic, A. Kruszynska, I. Lambrescu, S. Lang, A. Luger, N. Marpole, S. Martin, M. Martinie, O. Moros, J. Newell-Price, M. Orbetzova, I. Paiva, F. Pecori Giraldi, A. M. Pereira, J. Pickel, V. Pirags, O. Ragnarsson, A. D. Reghina, P. Riesgo, M. Roberts, S. Roerink, O. Roig, C. Rowan, P. Rudenko, M. A. Sahnoun, J. Salvador, H. A. Sigurjonsdottir, T. Skoric Polovina, R. Smith, B. Stachowska, G. Stalla, J. Tóke, E. Ubina, S. Vinay, M. Wagenmakers, S. Werner, J. Young, P. Zdunowski, K. Zopf, S. Zopp, I. Zosin

Research output: Contribution to journalReview article

Abstract

Objective: To evaluate which tests are performed to diagnose hypercortisolism in patients included in the European Registry on Cushing's syndrome (ERCUSYN), and to examine if their use differs from the current guidelines. Patients and methods: We analyzed data on the diagnostic tests performed in 1341 patients with Cushing's syndrome (CS) who have been entered into the ERCUSYN database between January 1, 2000 and January 31, 2016 from 57 centers in 26 European countries. Sixty-seven percent had pituitary-dependent CS (PIT-CS), 24% had adrenaldependent CS (ADR-CS), 6% had CS from an ectopic source (ECT-CS) and 3% were classified as having CS from other causes (OTH-CS). Results: Of the first-line tests, urinary free cortisol (UFC) test was performed in 78% of patients, overnight 1 mg dexamethasone suppression test (DST) in 60% and late-night salivary cortisol (LSaC) in 25%. Use of LSaC increased in the last five years as compared with previous years (P < 0.01). Use of HDDST was slightly more frequent in the last 5 years as compared with previous years (P < 0.05). Of the additional tests, late-night serum cortisol (LSeC) was measured in 62% and 48-h 2 mg/day low-dose dexamethasone suppression test (LDDST) in 33% of cases. ACTH was performed in 78% of patients. LSeC and overnight 1 mg DST supported the diagnosis of both PIT-CS and ADR-CS more frequently than UFC (P < 0.05).

Original languageEnglish
Pages (from-to)613-624
Number of pages12
JournalEuropean Journal of Endocrinology
Volume176
Issue number5
DOIs
Publication statusPublished - May 1 2017

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Valassi, E., Franz, H., Brue, T., Feelders, R. A., Netea-Maier, R., Tsagarakis, S., Webb, S. M., Yaneva, M., Reincke, M., Droste, M., Komerdus, I., Maiter, D., Kastelan, D., Chanson, P., Pfeifer, M., Strasburger, C. J., Tóth, M., Chabre, O., Tabarin, A., ... Zosin, I. (2017). Diagnostic tests for Cushing's syndrome differ from published guidelines: Data from ERCUSYN. European Journal of Endocrinology, 176(5), 613-624. https://doi.org/10.1530/EJE-16-0967