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周期性库欣综合征——诊断难题。

Cyclic Cushing's Syndrome - A Diagnostic Challenge.

机构信息

Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Department of Obstetrics, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Front Endocrinol (Lausanne). 2021 Apr 22;12:658429. doi: 10.3389/fendo.2021.658429. eCollection 2021.

Abstract

Cyclic Cushing's syndrome (also known as intermittent or periodic) is a disease characterized by periods of transient hypercortisolemia shifting into periods of normo- and/or hypocortisolemia. Diagnosis of cyclic Cushing's syndrome is based on at least three periods of confirmed hypercortisolemia interspersed by two periods of normocortisolemia. Cyclic Cushing's syndrome is one of the greatest challenges in modern endocrinology due to its diverse clinical picture, unpredictable duration and frequency of phases, and various etiologies. We discuss a diagnostic algorithm for periodic hypercortisolemia with special regard to hair cortisol analysis and desmopressin stimulation test which both seem to be helpful in finding the correct answer.

摘要

周期性库欣综合征(也称为间歇性或周期性)是一种以皮质醇过多症的短暂时期交替出现正常和/或低皮质醇血症为特征的疾病。周期性库欣综合征的诊断基于至少三个确认的皮质醇过多症时期,其间穿插两个正常皮质醇血症时期。由于其临床表现多样、各阶段的持续时间和频率不可预测以及各种病因,周期性库欣综合征是现代内分泌学面临的最大挑战之一。我们讨论了周期性皮质醇过多症的诊断算法,特别关注毛发皮质醇分析和去氨加压素刺激试验,这两种方法似乎都有助于找到正确答案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8418/8101412/7ecb0772387a/fendo-12-658429-g001.jpg

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