The Diagnostic Standard of Preclinical Cushing's Syndrome : Evaluation of the Dexamethasone Suppression Test Using Various Cortisol Kits

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著者

    • ODAGIRI EMI
    • Central Clinical Laboratories, Department of Clinical Laboratory, Tokyo Women's Medical University School Medicine
    • NARUSE MITSUHIDE
    • Institute of Clinical Endocrinology, Department of Medicine, Tokyo Women's Medical University School of Medicine
    • TERASAKI KAZUYO
    • Central Clinical Laboratories, Department of Clinical Laboratory, Tokyo Women's Medical University School Medicine
    • YAMAGUCHI NOBUYUKI
    • Central Clinical Laboratories, Department of Clinical Laboratory, Tokyo Women's Medical University School Medicine
    • JIBIKI KAZUKO
    • Central Clinical Laboratories, Department of Clinical Laboratory, Tokyo Women's Medical University School Medicine
    • TAKAGI SACHIKO
    • Institute of Clinical Endocrinology, Department of Medicine, Tokyo Women's Medical University School of Medicine
    • TANABE MASAYO
    • Institute of Clinical Endocrinology, Department of Medicine, Tokyo Women's Medical University School of Medicine
    • TAKANO KAZUE
    • Institute of Clinical Endocrinology, Department of Medicine, Tokyo Women's Medical University School of Medicine

抄録

Incidental discovery of an adrenal mass, the so-called adrenal incidentaloma, has been increasing due to the advances in non-invasive diagnostic imaging tools. The criteria of diagnosis for preclinical Cushing's syndrome (preCS) in Japan were made by Nawata <i>et al</i>. supported by the Ministry of Health and Welfare in 1995. The results of suppression of cortisol by dexamethasone (DEX) (plasma cortisol above 3 μg/dl after 1 mg of DEX and above 1 μg/dl after 8 mg of DEX) are essential for the diagnosis of preCS due to an adrenal adenoma. However, plasma cortisol levels after the two doses of DEX suppression tests were found to be discrepant and repeated DEX suppression tests sometimes yielded different results. Therefore, we examined the cortisol values of DEX suppression tests in patients with preCS using four different cortisol assay kits: Amerlex cortisol kit (AMA), SPAC-S cortisol kit (SPA), ADVIA-Centaur cortisol assay (ADV) and ECLusys 2010 cortisol assay (ECL). The diagnosis for preCS was done using the AMA kit. Correlation between the kits was good. However, cortisol levels measured by SPA, ADV and ECL were lower than those measured by AMA. In the 1 mg DEX test, the cortisol levels measured with the SPA, ADV and ECL kits were suppressed in 2 patients with preCS. With 8 mg of DEX, cortisol levels measured with the SPA and ADV kits were suppressed in 2 patients with preCS. The diagnosis of preCS is decided by the cortisol kit used, but the cortisol levels differ among the kits. It is suggested that the lack of the standardization of cortisol measurement is one of the causes of confusion in the diagnosis of preCS.<br>

収録刊行物

  • Endocrine journal

    Endocrine journal 51(3), 295-302, 2004-06-01

    The Japan Endocrine Society

参考文献:  14件中 1-14件 を表示

被引用文献:  12件中 1-12件 を表示

各種コード

  • NII論文ID(NAID)
    10013292855
  • NII書誌ID(NCID)
    AA10901436
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    09188959
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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