Vlera e kortizolit të lirë urinar në diagnostikimin e sindromës Cushing: Eksperienca jonë
DOI:
https://doi.org/10.55312/op.vi1.4386Abstract
Qëllimi i këtij studimi ka qenë vlerësimi i sensitivitetit të përdorimit të kortizolit të lirë urinar në diagnostikimin e sindromës Cushing dhe krahasimi i saj me testin e frenimit me dexametazon. Nëntëmbëdhjetë raste të diagnostikuar me sindromën Cushing, insufi ciencën adrenale kronike dhe incidentalomë adrenale për periudhën janar 2011- dhjetor 2014 u morën në një studim retrospektivë për vlerësimin e sensibilitetit te kortizolit të lirë urinar në diagnostikimin e sindromën Cushing. Sensitiviteti i kortizolit të lirë urinar në rastet e marra në studim ishte i ulur 28%. Nga pacientët e diagnostikuar me sindromën Cushing raporti femra/ meshkuj ishte 1:6. Shpërndarja sipas faktorit etiologjik: 28% të rasteve adenoma surenale, 28% të rasteve me mikroadenomë hipofi zare dhe 46% të rasteve me makroadenomë hipofi zare. 28% të rasteve kishin edhe diabet mellitus si edhe HTA si diagnoza bashkë shoqëruese të sindromës Cushing. Si përfundim, në studimin tonë u vu re një sensibilitet i ulur i kortizolit të lirë urinar, si një nga testet fi llestare të diagnostikimit të sindromës Cushing, duke venë në pikëpyetje përdorimin ose jo të këtij testi diagnostik në të ardhmen.Keywords:
sindroma Cushing, kortizoli i lirë urinar, testi i frenimit me dexametazon.Downloads
References
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- Larsen K, Polonsky M. Williams test book of endocrinology, 2003; pp. 508-509.
-
- Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008 May; 93(5):1526-40.
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- Chan KC, Lit LC, Law EL, et al. Diminished urinary free cortisol excretion in patients with moderate and severe renal impairment. Clin Chen 2004; 50;757.
-
- Mericq MV, Cutler GB, Jr. High fl uid intake increases urine free cortisol excretion in normal subjects. J Clin Endocrinol Metabol 1998; 83; 682.
-
- Elamin MB, Murad MH, Mullan R, et al. Accuracy of diagnostic test for Cushing’s syndrome: a systematic review and metaanalyses.
-
J Clin Endocrinol 2008; 98: 1553.
-
- Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome : an Endocrine Society Clinical Practice Guidelines. J Clin
-
Endocrinol Metab 2008; 98: 1526.
-
- Pecori Giraldi F, Ambragio AG, De Martin M, et al. Specifi city of fi rst line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab 2007; 92:4123.
-
- Raff H, Raff JL, Finling JW. Late-night salivary cortisol as a sreeaning test for Cushing’s syndrome. Journal Of Clinical Endocrinology and Metabolism 1998 86 2681-2683.
-
- Castro M, Elias PC, Quidute AR, Halah FP & Moreira AC. Out –patient screening for Cushing’s: the sensitivity of the combination of circadian rhythm and overnight dexametasone suppression salivary cortisol test. Journal of Clinical of Endocrinology and Metabolism 1999 84 878-882.
-
- Papanicolau DA, Yanovski JA, Cutler GB, Jr, Chrousos GP & Nieman LK. A single midnight serum cortisol measurement distinguishes
-
syndrome from pseudo-Cushing stades. Journal of Clinical Endocrinolog and Metabolism. 1998 83 1163-1167.
-
- Viardot A, Huber P, Puder JJ, Zulewski H, Keller U & Muller B. Reproducibility of night time salivary cortisol and its use in the diagnosis
-
of hyperkortisolism compared with urinary free cortisol and overnight dexametasone suppression test. Journal of Clinical of Endocrinol Metabolism 2005 90 5730-5736.
References
- Larsen K, Polonsky M. Williams test book of endocrinology, 2003; pp. 508-509.
- Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008 May; 93(5):1526-40.
- Chan KC, Lit LC, Law EL, et al. Diminished urinary free cortisol excretion in patients with moderate and severe renal impairment. Clin Chen 2004; 50;757.
- Mericq MV, Cutler GB, Jr. High fl uid intake increases urine free cortisol excretion in normal subjects. J Clin Endocrinol Metabol 1998; 83; 682.
- Elamin MB, Murad MH, Mullan R, et al. Accuracy of diagnostic test for Cushing’s syndrome: a systematic review and metaanalyses.
J Clin Endocrinol 2008; 98: 1553.
- Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome : an Endocrine Society Clinical Practice Guidelines. J Clin
Endocrinol Metab 2008; 98: 1526.
- Pecori Giraldi F, Ambragio AG, De Martin M, et al. Specifi city of fi rst line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab 2007; 92:4123.
- Raff H, Raff JL, Finling JW. Late-night salivary cortisol as a sreeaning test for Cushing’s syndrome. Journal Of Clinical Endocrinology and Metabolism 1998 86 2681-2683.
- Castro M, Elias PC, Quidute AR, Halah FP & Moreira AC. Out –patient screening for Cushing’s: the sensitivity of the combination of circadian rhythm and overnight dexametasone suppression salivary cortisol test. Journal of Clinical of Endocrinology and Metabolism 1999 84 878-882.
- Papanicolau DA, Yanovski JA, Cutler GB, Jr, Chrousos GP & Nieman LK. A single midnight serum cortisol measurement distinguishes
syndrome from pseudo-Cushing stades. Journal of Clinical Endocrinolog and Metabolism. 1998 83 1163-1167.
- Viardot A, Huber P, Puder JJ, Zulewski H, Keller U & Muller B. Reproducibility of night time salivary cortisol and its use in the diagnosis
of hyperkortisolism compared with urinary free cortisol and overnight dexametasone suppression test. Journal of Clinical of Endocrinol Metabolism 2005 90 5730-5736.
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