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August 30, 1965

A Rapid Screening Test for Cushing's Syndrome

Author Affiliations

From the Metabolic Research Unit and the Department of Medicine, University of California School of Medicine, San Francisco. Dr. Pavlatos is now at the University Clinic of Internal Medicine, King Paul Hospital, Athens, Greece.

JAMA. 1965;193(9):720-723. doi:10.1001/jama.1965.03090090026005

The suppressibility of morning plasma 17-hydroxycorticosteroid (17-OHCS) levels by 1 mg dexamethasone given by mouth at 11 pm the preceding night was used as a screening test for Cushing's syndrome. Plasma 17-OHCS in 16 normal subjects, 20 with simple obesity and 10 with diseases other than Cushing's syndrome were suppressed to levels below 5μg/100 ml. In contrast, in 17 patients with Cushing's syndrome, the lowest observed value was 13μg/100 ml and no false-negative results were obtained. Two obese, hirsute women proved to be partial responders only, as their plasma levels were not suppressed below 10.5μg/100 ml. Mild abnormalities of adrenal cortical secretory activity may be present in such cases. Therefore, a single morning 17-OHCS value of less than 5μg/100 ml plasma should exclude Cushing's syndrome.