| Autor: |
Mike Besser, John Newell-Price |
| Rok vydání: |
2002 |
| Předmět: |
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| Zdroj: |
Cushing’s Syndrome ISBN: 9781461353966 |
| DOI: |
10.1007/978-1-4615-1103-8_5 |
| Popis: |
The protean clinical manifestations of Cushing’s syndrome (CS) are really only the starting point for biochemical evaluation. When florid clinical features are present diagnosis may be straightforward. In contrast, when physical symptoms and signs are subtle diagnosis may be far more taxing. The principal biochemical features of Cushing’s syndrome are an excess endogenous integrated secretion of cortisol, loss of the normal feed-back of the hypothalamo-pituitary-adrenal axis (HPA) and disturbance of the normal circadian rhythm of cortisol secretion. The biochemical tests that are used in the diagnosis of Cushing’s syndrome rely upon these disturbances of normal physiology. In the investigation of Cushing’s syndrome initial biochemical tests of high sensitivity should be employed to avoid missing mild disease, although the diagnosis may latter be refuted by tests of higher specificity. Differential diagnosis can only be embarked upon once the diagnosis of Cushing’s syndrome is firmly established. In this chapter we will review the biochemical tests used for diagnosis and differential diagnosis. Imaging tests are discussed in the relevant chapters. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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