Cushing's Syndrome

A condition caused by prolonged exposure to high cortisol levels. ACTH-dependent forms include pituitary adenomas (Cushing's disease) and ectopic ACTH secretion. Diagnosis requires differentiating the source of excess ACTH, often using CRH stimulation testing.

Quick Answer

What it is

A condition caused by prolonged exposure to high cortisol levels. ACTH-dependent forms include pituitary adenomas (Cushing's disease) and ectopic ACTH secretion.

Key findings

  • Grade A: Cushing's Disease Diagnosis (Corticorelin Ovine (Acthrel))
  • Grade A: ACTH/Cortisol Response (Corticorelin Ovine (Acthrel))
  • Grade A: Ectopic ACTH Exclusion (Corticorelin Ovine (Acthrel))

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

ℹ️ Quick Facts

Quick Facts: Cushing's Syndrome

  • Supplements Studied:1
1 supps · 3 outcomes

Detailed Outcomes

A
Cushing's Disease Diagnosis
CRH test sensitivity 86-93%, specificity 90-100% for Cushing's disease. 93/100 patients with Cushing's disease showed ≥35% ACTH increase, 0/16 with ectopic ACTH. Superior to dexamethasone suppression test (91% vs 75% accuracy).
largeImproves
A
ACTH/Cortisol Response
Positive criteria: ≥35-40% ACTH increase and/or ≥20% cortisol increase. ≥40% cortisol increase most specific (PPV 99%). Peak response at 15-30 minutes. Absent response in ectopic ACTH syndrome.
largeWorsens
A
Ectopic ACTH Exclusion
Ectopic ACTH tumors fail to respond to CRH stimulation. 0% of ectopic ACTH patients show positive response. False negative rate in Cushing's disease 5-10%. Ovine CRH preferred over human CRH for higher sensitivity.
largeImproves

Research Citations (10)

Ovine CRH Stimulation and 8 mg Dexamethasone Suppression Tests in 323 Patients With ACTH-Dependent Cushing's Syndrome
(2024)
PMID: 37751584
Outcome of CRH stimulation test and overnight 8 mg dexamethasone suppression test in 469 patients with ACTH-dependent Cushing's syndrome
(2022)
PMID: 36223544
Usefulness of combined testing with CRH and desmopressin to differentiate Cushing's syndrome from pseudo-Cushing's states
(2006)
PMID: 16522696
The corticotropin-releasing hormone test in the diagnosis of ACTH-dependent Cushing's syndrome: a reappraisal
(2001)
PMID: 11380490
A simplified morning ovine corticotropin-releasing hormone stimulation test for the differential diagnosis of adrenocorticotropin-dependent Cushing's syndrome
(1993)
PMID: 8077325
The dexamethasone-suppressed corticotropin-releasing hormone stimulation test differentiates mild Cushing's disease from normal physiology
(1993)
PMID: 3944403
Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing's syndrome
(1991)
PMID: 7934519
The ovine corticotropin-releasing hormone (CRH) stimulation test is superior to the human CRH stimulation test for the diagnosis of Cushing's disease
(1989)
PMID: 2543689
The ovine corticotropin-releasing hormone stimulation test and the dexamethasone suppression test in the differential diagnosis of Cushing's syndrome
(1986)
PMID: 3022629
Responses of plasma adrenocorticotropin, cortisol, and dehydroepiandrosterone to ovine corticotropin-releasing hormone in healthy aging men
(1986)
PMID: 2539850