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Título: Recommendations of the neuroendocrinology department of the Brazilian society of endocrinology and metabolism for the diagnosis of Cushing’s disease in Brazil
Autor(es): Machado, Márcio Carlos
Fragoso, Maria Candida Barisson Vilares
Moreira, Ayrton Custódio
Boguszewski, César Luiz
Vieira Neto, Leonardo
Naves, Luciana A.
Vilar, Lucio
Araújo, Luiz Antônio de
Czepielewski, Mauro A.
Gadelha, Monica R.
Musolino, Nina Rosa Castro
Miranda, Paulo Augusto C.
Bronstein, Marcello Delano
Oliveira Júnior, Antônio Ribeiro
Assunto: Cushing, Doença de - diagnóstico
Síndrome de Cushing
Data de publicação: Jun-2016
Editora: Sociedade Brasileira de Endocrinologia e Metabologia
Referência: MACHADO, Márcio Carlos et al. Recommendations of the neuroendocrinology department of the Brazilian society of endocrinology and metabolism for the diagnosis of Cushing’s disease in Brazil. Archives of Endocrinology and Metabolism, São Paulo, v. 60, n. 3, p. 267-286, jun. 2016. Disponível em: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000300267&lng=en&nrm=iso>. Acesso em: 11 dez. 2017. doi: http://dx.doi.org/10.1590/2359-3997000000174.
Abstract: Although it is a rare condition, the accurate diagnosis and treatment of Cushing’s disease is important due to its higher morbidity and mortality compared to the general population, which is attributed to cardiovascular diseases, diabetes mellitus and infections. Screening for hypercortisolism is recommended for patients who present multiple and progressive clinical signs and symptoms, especially those who are considered to be more specific to Cushing’s syndrome, abnormal findings relative to age (e.g., spinal osteoporosis and high blood pressure in young patients), weight gain associated with reduced growth rate in the pediatric population and for those with adrenal incidentalomas. Routine screening is not recommended for other groups of patients, such as those with obesity or diabetes mellitus. Magnetic resonance imaging (MRI) of the pituitary, the corticotropin-releasing hormone (CRH) test and the high-dose dexamethasone suppression test are the main tests for the differential diagnosis of ACTH-dependent Cushing’s syndrome. Bilateral and simultaneous petrosal sinus sampling is the gold standard method and is performed when the triad of initial tests is inconclusive, doubtful or conflicting. The aim of this article is to provide information on the early detection and establishment of a proper diagnosis of Cushing’s disease, recommending follow-up of these patients at experienced referral centers.
Licença: Archives of Endocrinology and Metabolism - This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0). Fonte: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000300267&lng=en&nrm=iso. Acesso em: 11 dez. 2017.
DOI: http://dx.doi.org/10.1590/2359-3997000000174
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