Biomaterial Database

[False positive dexamethasone suppression test in a patient being treated with carbamazepine]. 2014

Ane Bull Iversen, and Christian Trolle, and Per Løgstrup Poulsen

Medicinsk Endokrinologisk Afdeling, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C. anebiversen@gmail.com.

We present a case story of a patient suspected having Cushing's syndrome (CS), with spuriously elevated P-cortisol level diagnosed by overnight and two days dexamethasone suppression test (DST). The patient was being treated with carbamazepine, and after two weeks withdrawal from this drug, both two-day DST and urinary free cortisol showed normal results. There are many pitfalls in the process of diagnosing CS. Several conditions mimic the disease and others cause hypercortisolism. Liver and kidney failure as well as several drugs can influence the test results. It is important to bare this in mind during the diagnostic work-up of suspected CS.

UI	MeSH Term	Description	Entries
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D002220	Carbamazepine	A dibenzazepine that acts as a sodium channel blocker. It is used as an anticonvulsant for the treatment of grand mal and psychomotor or focal SEIZURES. It may also be used in the management of BIPOLAR DISORDER, and has analgesic properties.	Amizepine,Carbamazepine Acetate,Carbamazepine Anhydrous,Carbamazepine Dihydrate,Carbamazepine Hydrochloride,Carbamazepine L-Tartrate (4:1),Carbamazepine Phosphate,Carbamazepine Sulfate (2:1),Carbazepin,Epitol,Finlepsin,Neurotol,Tegretol
D003480	Cushing Syndrome	A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent.	Cushing's Syndrome,Hypercortisolism,Syndrome, Cushing,Syndrome, Cushing's
D003907	Dexamethasone	An anti-inflammatory 9-fluoro-glucocorticoid.	Hexadecadrol,Decaject,Decaject-L.A.,Decameth,Decaspray,Dexasone,Dexpak,Hexadrol,Maxidex,Methylfluorprednisolone,Millicorten,Oradexon,Decaject L.A.
D004347	Drug Interactions	The action of a drug that may affect the activity, metabolism, or toxicity of another drug.	Drug Interaction,Interaction, Drug,Interactions, Drug
D005189	False Positive Reactions	Positive test results in subjects who do not possess the attribute for which the test is conducted. The labeling of healthy persons as diseased when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed)	False Positive Reaction,Positive Reaction, False,Positive Reactions, False,Reaction, False Positive,Reactions, False Positive
D005260	Female		Females
D005938	Glucocorticoids	A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system.	Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014277	Trigeminal Neuralgia	A syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the TRIGEMINAL NERVE. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. Associated conditions include MULTIPLE SCLEROSIS, vascular anomalies, ANEURYSMS, and neoplasms. (Adams et al., Principles of Neurology, 6th ed, p187)	Tic Doloureux,Tic Douloureux,Epileptiform Neuralgia,Fothergill Disease,Secondary Trigeminal Neuralgia,Trifacial Neuralgia,Trigeminal Neuralgia, Idiopathic,Trigeminal Neuralgia, Secondary,Disease, Fothergill,Epileptiform Neuralgias,Idiopathic Trigeminal Neuralgia,Idiopathic Trigeminal Neuralgias,Neuralgia, Epileptiform,Neuralgia, Idiopathic Trigeminal,Neuralgia, Secondary Trigeminal,Neuralgia, Trifacial,Neuralgia, Trigeminal,Secondary Trigeminal Neuralgias,Trifacial Neuralgias,Trigeminal Neuralgias