Iversen Ane Bull, Trolle Christian, Poulsen Per Løgstrup
Medicinsk Endokrinologisk Afdeling, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C.
Ugeskr Laeger. 2014 Jan 13;176(3A):V04130254.
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.
我们报告一例疑似库欣综合征(CS)患者的病例,其通过过夜及两日地塞米松抑制试验(DST)诊断为假性升高的血皮质醇水平。该患者正在服用卡马西平,在停用该药两周后,两日DST及尿游离皮质醇均显示正常结果。CS诊断过程中有许多陷阱。几种情况可模拟该疾病,其他情况则导致皮质醇增多症。肝肾功能衰竭以及几种药物可影响检测结果。在疑似CS的诊断检查过程中牢记这一点很重要。