Proposed diagnostic criteria for subclinical Cushing’s syndrome associated with adrenal incidentaloma

Contralateral adrenal suppression on adrenocortical scintigraphy provides good evidence showing subclinical cortisol overproduction from unilateral adenomas

“…The prevalence of CV events was not significantly different between the SCS and NFA groups (13.6% and 5.9%, respectively, p = 0.0814). Serum cortisol levels at 2400 h and serum cortisol levels after 1-mg DST were significantly higher in the SCS group than in the NFA group (8.9 ± 3.7 and 4.6 ± 3.0 μg/dL, respectively, p < 0.001; and 7.5 ± 4.3 and 1.8 ± 0.7 ACTH < 10 pg/mL or serum cortisol levels ≥ 5.0 μg/dL at 2400 h, and they showed it had high sensitivity and specificity for the detection of impaired glucose tolerance (IGT)-DM [12]. Therefore, we decided to use this diagnostic procedure (hereinafter referred as to criteria B) for SCS as well.…”

In the overnight dexamethasone suppression test, 1.0 mg loading is superior to 0.5 mg loading for diagnosing subclinical adrenal Cushing’s syndrome based on plasma dexamethasone levels determined using liquid chromatography-tandem mass spectrometry

“…This diagnostic method followed the criteria set forth by the MHLW, Japan [6]. The Endocrine Society guidelines [5] and a recent report from Japan [16] proposed an alternative cut-off of serum cortisol >1.8 μg/ dL after the 1-mg DST for the diagnosis of adrenal SCS. Therefore, we also used this value for determination of DST results.…”

D-dimer as a significant marker of deep vein thrombosis in patients with subclinical or overt Cushing’s syndrome

“…Written informed consent was obtained from all patients. The diagnosis of soCS was based on general diagnostic criteria as previously described [18,19]. The etiologies of soCS include Cushing's disease [20], ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS), CS due to adrenal adenoma (aCS), and subclinical CS due to adrenal adenoma (SCS).…”