Effect of Estrogens on the Dexamethasone Suppression Test in Nondepressed Women

Dommisse, Cynthia S.; Hayes, Peggy E.; KWENTUS, JOSEPH A.

doi:10.1097/00004714-198505060-00002

Cited by 4 publications

(5 citation statements)

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“…Twenty-three of the 40 patients had been transferred to the Clinical Research Center after having spent two or more days in the psychiatric ward and thus were in-patients at the time of neuroendocrine testing; the other 17 were out-patients. In this report all patients are included as a group (Table 1), since no clear differences in HPA activity, including DST results, have been demonstrated for men v. women, women with or without low-dose oestrogen replacement (Dommisse et al 1985), Caucasians v. Blacks, etc. We also found no systematic differences in HPA activity related to these variables in our patients.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Neuroendocrine aspects of primary endogenous depression III. Cortisol secretion in relation to diagnosis and symptom patterns

et al. 1987

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SynopsisIn order to ascertain the extent of hypothalamo-pituitary-adrenal cortical (HPA) hyperactivity in endogenous depression, we determined circadian serum cortisol patterns, cortisol responses to dexamethasone (DEX) administration, and urine free cortisol excretion before and after DEX administration in 40 definite endogenous depressives diagnosed with the Research Diagnostic Criteria. The cortisol measures ranged from normal to clearly elevated. To elucidate the clinical correlates of these hormone measures in the patients, we examined the relationships of the pre- and post-DEX cortisol measures to the diagnosis of endogenous/melancholic depression by different systems and to the overall severity and specific dimensions of depressive symptomatology.In this group of endogenous depressives, none of the diagnostic schemes for endogenous/melancholic depression which we studied was significantly related to the pre- or post-DEX cortisol measures. Of the other subject and symptom variables, only age and the agitation/anxiety factor of the Hamilton depression scale showed consistent relationships with the cortisol measures. Both were positively correlated, to a moderate degree, with the hormone measures, and they were not correlated with each other. Together they explained approximately 20% of the variance in the cortisol measures. Thus, within a group of moderately to severely ill endogenous depressives, the older and the more agitated anxious patients have a significantly greater likelihood of showing increased HPA activity. These findings indicate that age should be controlled in studies of the HPA axis and that the subjective experience of anxiety may contribute to HPA hyperactivity in endogenous depression.

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Section: Patient Characteristicsmentioning

confidence: 99%

Neuroendocrine aspects of primary endogenous depression III. Cortisol secretion in relation to diagnosis and symptom patterns

et al. 1987

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“…1,2 However, most studies were performed in the 1980s, a time when other cut-off values for cortisol concentrations were applied. Domisse et al found almost all of the patients studied to show adequate suppression of cortisol on OC (containing 0Á05 and 0Á08 mg mestranol) employing 138 nmol/L (5 lg/dL) as the cut-off for adequate suppression, 3 while Nickelsen et al reported false-positive rates for the overnight DST in 50% of women taking the oral contraceptive pill [0Á03-0Á05 mg ethinylestradiol (EE2)]. 2 There is, however, little information on whether the same is true for women on oral contraception from systematic investigations.…”

Section: False Positives On Both Dexamethasone Testing and Urinary Frmentioning

confidence: 97%

“…We read with interest the article by Kim et al 1 We congratulate the authors for addressing one of the most important aspects related to the treatment of papillary microcarcinomas, namely the avoidance of over-treatment of this indolent disease with radioactive iodine. [1][2][3][4] We appreciate the use of the standardized inverse probability of treatment weighted model for statistical analysis, to avoid the need for huge numbers in each arm. We have several questions regarding their management.…”

Section: Supporting Informationmentioning

confidence: 99%

False positives on both dexamethasone testing and urinary free cortisol in women on oral contraception: dose–response effects.

Paschali

Willenberg

Fritzen³

et al. 2013

Clinical Endocrinology

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“…Endocrine Society guideline recommends positivity of at least two urinary free cortisol levels, an overnight dexamethasone suppression test, at least two late-night salivary cortisol levels or low dose dexamethasone suppression test for diagnosis of hypercortisolism once exogenous cortisol intake is excluded (3) . Recent use of oral contraceptive pills was excluded to avoid confusion with high serum cortisol levels due to high cortisol binding globulin (4) . As the test was done in the hospital, it was ensured the correct doe of dexamethasone was taken at the correct timing.…”

Section: Thementioning

confidence: 99%

Invasive giant pituitary macroadenoma causing Cushing disease; a case report

Gamage

Pathmanathan

Somasundaram

et al. 2021

Sri Lanka J. Diabetes Endocrinol. Metab.

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Introduction: Cushing disease is a rare entity, and among them, giant pituitary adenomas causing Cushing disease is rarer. Here we present a case of Cushing disease secondary to a giant pituitary macroadenoma.Case report: A 41-year-old female with poorly controlled diabetes mellitus and hypertension diagnosed for six months presented with a history of unintentional weight loss, polyuria and polydipsia for the same duration. There was change in her facial appearance with increased pigmentation, frontal balding and she also noted increase in the size of her abdomen. There were features of proximal muscle weakness. Symptoms of hypothyroidism, hypoadrenalism or hyperprolactinemia were absent, and she was amenorrhoeic following hysterectomy done a year back. Visual impairment, headache, abdominal pain, features suggestive of internal malignancy, especially lung and renal, including features of pheochromocytoma were absent. She denied a family history of similar illness.Her BMI was 20.44 kg/m -2 . She had a prominent abdomen, round facies, hirsutism, male pattern hair loss, facial plethora and generalized pigmentation and thinning of skin. She also had hypertension and proximal muscle weakness. Rest of the examination was normal. Investigations revealed hypokalaemia, poorly controlled hyperglycaemia and, non-suppressed overnight dexamethasone suppression test. She had a elevated ACTH level, and a high dose dexamethasone suppression test showed suppression. Pituitary imaging with MRI revealed a 51x 62x 41 mm size sellar and a para sellar mass with heterogeneous echogenicity extending to the right temporal lobe. Further imaging for ectopic ACTH secretion was negative. She underwent transcranial surgery which was unsuccessful due to intraoperative bleeding, and radiotherapy was given postoperatively. Conclusion:Cushing disease due to giant pituitary macroadenomas are rare and may require secondary therapeutic measures in controlling the disease in case of failed surgery.

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Effect of Estrogens on the Dexamethasone Suppression Test in Nondepressed Women

Cited by 4 publications

References 0 publications

Neuroendocrine aspects of primary endogenous depression III. Cortisol secretion in relation to diagnosis and symptom patterns

Neuroendocrine aspects of primary endogenous depression III. Cortisol secretion in relation to diagnosis and symptom patterns

False positives on both dexamethasone testing and urinary free cortisol in women on oral contraception: dose–response effects.

Invasive giant pituitary macroadenoma causing Cushing disease; a case report

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