Androulakis Ioannis I, Kaltsas Gregory, Chrousos George
Endocrine unit, Department of Pathophysiology, Medical School, University of Athens, Athens, Greece
Professor of Medicine, Department of Pathophysiology, National & Kapodistrian University of Athens 115 27, Greece. email:
(PCS) is a medical condition in which patients display the signs, symptoms, and abnormal hormone levels seen in Cushing's syndrome (CS). However, PCS is not caused by a problem of the hypothalamic-pituitary-adrenal axis as Cushing's syndrome but constitutes a heterogeneous group of disorders, either physiological (like surgery associated stress, severe illness or emotional stress) or non-physiological (like chronic alcoholism and withdrawal syndrome, major depression or poorly controlled diabetes mellitus) that lead to increased cortisol production and stigmata of hypercortisolism. The discrimination between CS and PCS is often difficult because many symptoms of CS are also prevalent in PCS. Furthermore, the substantial overlap of biochemical tests commonly used for the diagnosis of makes the differentiation of true, particularly mild CS from PCS challenging for the physician. Biochemical tests commonly used for the diagnosis of CS include midnight serum or salivary cortisol, dexamethasone-CRH Test and desmopressin Test. No test warrants 100% diagnostic accuracy and further studies with a larger number of patients with mild CS and pseudo-Cushing’s state evaluating the diagnostic accuracy of each of tests alone or their combination are necessary.
伪库欣综合征（PCS）是一种医学状况，患者会出现库欣综合征（CS）的体征、症状和异常激素水平。然而，与库欣综合征不同，PCS并非由下丘脑-垂体-肾上腺轴问题引起，而是一组异质性疾病，包括生理性（如手术相关应激、重症或情绪应激）或非生理性（如慢性酒精中毒和戒断综合征、重度抑郁症或控制不佳的糖尿病），这些情况会导致皮质醇分泌增加和皮质醇增多症的体征。区分CS和PCS往往很困难，因为CS的许多症状在PCS中也很常见。此外，常用于诊断的生化检查存在大量重叠，这使得医生难以区分真正的，尤其是轻度的CS与PCS。常用于诊断CS的生化检查包括午夜血清或唾液皮质醇、地塞米松-促肾上腺皮质激素释放激素试验和去氨加压素试验。没有一种检查能保证100%的诊断准确性，因此有必要对更多轻度CS和假性库欣状态患者进行进一步研究，评估每种检查单独或联合使用时的诊断准确性。
