There is some evidence these patients may have subtle steroid hormone changes not identified by the usual testing and more detailed analysis of adrenocortical hormone is required . See
Clin Endocrinol Metab. 2011 Dec;96(12):3775-84. Epub 2011 Sep 14.
Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors.
Arlt W, Biehl M, Taylor AE, Hahner S, Libé R, Hughes BA, Schneider P, Smith DJ, Stiekema H, Krone N, Porfiri E, Opocher G, Bertherat J, Mantero F, Allolio B, Terzolo M, Nightingale P, Shackleton CH, Bertagna X, Fassnacht M, Stewart PM.
SourceCentre for Endocrinology, Diabetes, and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, United Kingdom. [log in to unmask]
Ahmed Waise
Laboratory Medicine
York Hospital
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Fiona Davidson
Sent: 29 November 2012 12:22
To: [log in to unmask]
Subject: ? Cushings
Dear all,
We currently have a patient very similar to the one posted here by Avril Wayte in August.
The patient is a 62 year old gentleman with an incidentally found adrenal mass, negative screen for phaeo and aldosteronism. Two 24 hour UFC have been well within the normal range at 38nmol and 44nmol but he has failed to suppress his cortisol post dexamethasone on several occassions (post dex cortisol 135-176nmol/L). He is asymptomatic, not obese and not depressed.
Unlike Avril's patient this gentleman is only on Thyroxine and Aspirin so drug interfernce seems unlikely?
Any suggestions would be very welcome!
Fiona Davidson
Pre-Reg Clinical Biochemist
Kingston Hospital NHS Trust
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------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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