Lambert et al listed criteria for the diagnosis of Cushing’s Disease. The authors are from Mount Sinai Medical Center in New York City.
Criteria of Cushing’s syndrome:
(1) clinical phenotype of Cushing syndrome
(2) one or more of the following:
(2a) elevated 24-hour urine free cortisol concentration
(2b) lack of serum cortisol suppression overnight after 1 mg dexamethasone administration (serum cortisol > 5 µg/dL)
(2c) elevated midnight salivary free cortisol
Criteria for identifying a pituitary source – one or more of the following:
(1) (pituitary adenoma on MRI) AND (after removal of the adenoma the serum cortisol < 5 µg/dL after 1 mg overnight dexamethasone suppression)
(2) (pituitary adenoma on MRI) AND (histologic evidence of corticotropin production in the adenoma)
(3) bilateral inferior petrosal sinus sampling (BIPSS) shows a central to peripheral ratio in serum ACTH concentration > 3:1
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Specialty: Endocrinology, Clinical Laboratory
ICD-10: ,