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The dexamethasone suppression test (DST) is used to assess adrenal gland function by measuring how cortisol levels change in response to oral doses or an injection of dexamethasone. [1] It is typically used to diagnose Cushing's syndrome .
Levels of cortisol and ACTH both elevated; 24-hour urinary cortisol levels elevated; Dexamethasone suppression test [3] Late night salivary cortisol (LNSC) [4] Loss of diurnal variation in cortisol levels (seen only in true Cushing's Syndrome) High mean corpuscular volume and gamma-glutamyl transferase may be clues to alcoholism
Two dexamethasone suppression tests (DSTs) are generally used, the overnight test and the 48 hour test. [8] For both tests, a plasma cortisol level above 50 nmol/L is indicative of Cushing's disease. [8] However, 3–8% of patients with Cushing's disease will test negative due to a retention of dexamethasone suppression abilities. [8]
Cushing's syndrome is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. [4] [9] [10] Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face due to facial plethora, [11] a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals ...
[2] [3] Dexamethasone should be used as the corticosteroid of choice in these cases as it is the only corticosteroid that will not affect diagnostic test results. [2] [29] To confirm inappropriately low cortisol secretion, testing can include baseline morning cortisol level in the blood or morning cortisol level in the saliva. [2]
High levels of cortisol observed in patients with PPNAD are not suppressed upon administration of dexamethasone (dexamethasone suppression test), and upon MRI or CT imaging, the pituitary will show no abnormalities. Measuring ACTH will confirm that the cause of the patients Cushing's syndrome is ACTH independent.
Dexamethasone is a fluorinated glucocorticoid medication [10] used to treat rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive pulmonary disease (COPD), croup, brain swelling, eye pain following eye surgery, superior vena cava syndrome (a complication of some forms of cancer), [11] and along with antibiotics in tuberculosis. [10]
The dexamethasone suppression test involves administering dexamethasone, a synthetic glucocorticoid, to the horse, and measuring its serum cortisol levels before and 19–24 hours after injection. In a normal horse, dexamethasone administration results in negative feedback to the pituitary, resulting in decreased ACTH production from the pars ...