-transparent.png){kind=logo}
Suppression of urinary corticosteroids during low-dose dexamethasone testing (0.5 mg every six hours eight times) has commonly been recognized as a response that excludes the diagnosis of Cushing's syndrome. Although "normal suppression" has been reported previously in Cushing's disease, rarely has an explanation been provided for this aberrant response. We report a case of proven Cushing's disease in which normal suppression was observed with low-dose dexamethasone testing. Further study suggested that this phenomenon, which is not widely recognized, was related to an abnormally decreased clearance of dexamethasone. We therefore suggest that whenever responses to testing appear discordant with the clinical index of suspicion, simultaneous plasma dexamethasone and cortisol levels should be obtained to exclude abnormalities in dexamethasone clearance.
L P Kapcala, and
S M Hamilton, and
A W Meikle
September 1978,
The Journal of clinical endocrinology and metabolism,
L P Kapcala, and
S M Hamilton, and
A W Meikle
January 1969,
Rassegna di neurologia vegetativa,
L P Kapcala, and
S M Hamilton, and
A W Meikle
August 1981,
Southern medical journal,
L P Kapcala, and
S M Hamilton, and
A W Meikle
April 1979,
Southern medical journal,
L P Kapcala, and
S M Hamilton, and
A W Meikle
March 1968,
The Journal of clinical endocrinology and metabolism,
L P Kapcala, and
S M Hamilton, and
A W Meikle
December 1974,
La Nouvelle presse medicale,
L P Kapcala, and
S M Hamilton, and
A W Meikle
January 1980,
The New England journal of medicine,
L P Kapcala, and
S M Hamilton, and
A W Meikle
January 2010,
Acta medica Iranica,
L P Kapcala, and
S M Hamilton, and
A W Meikle
August 1985,
Clinical endocrinology,
L P Kapcala, and
S M Hamilton, and
A W Meikle
August 1989,
Steroids,
