Laboratory Diagnosis of Cushing’s Disease and Syndrome

  • Dorothy T. Krieger
Part of the Monographs on Endocrinology book series (ENDOCRINOLOGY, volume 22)


With continued clinical studies of patients suspected of having hypercorticism, it has become evident that laboratory testing is essential to distinguish those who may have suggestive signs and symptoms, but may prove to be eucorticoid, from those patients who actually have increased corticosteroid production. In the latter group, it is further necessary to distinguish patients with Cushing’s disease from those with either adrenal or ectopic ACTH-producing tumors.


Plasma Cortisol Adrenal Tumor Plasma ACTH Urinary Free Cortisol Plasma Cortisol Level 
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  1. Abe K, Island DP, Liddle GW, Fleischer N, Nicholson WE (1967) Radioimmunologie evidence for α-MSH (melanocyte-stimulating hormone) in human pituitary and tumor tissues. J Clin Endocrinol Metab 27:46–52 PubMedCrossRefGoogle Scholar
  2. Ashcraft WM, Van Herle AJ, Vener SL, Geffner D (1979) Usefulness of measurement of serum Cortisol (F) and dehydroepiandrosterone sulfate (DHEA-S) in the diagnosis of patients with Cushing’s syndrome. 61st Meeting Endocrin. Soc., p233Google Scholar
  3. Bayliss RIS, Edwards OM, Starer F (1970) Complications of adrenal venography. Br J Radiol 43:531–533PubMedCrossRefGoogle Scholar
  4. Beierwaltes W, Lieberman LM, Ansari AN, Nishiyama H (1971) Visualization of human adrenal glands in vivo by scintillation scanning. JAMA 216:275–277PubMedCrossRefGoogle Scholar
  5. Beisel WR, Coss JJ, Horton R, Chao PY, Forsham PH (1964) Physiology of urinary Cortisol excretion. J Clin Endocrinol Metab 24:887–893PubMedCrossRefGoogle Scholar
  6. Beitins IZ, Rayard R, Kowarski A, Migeon CJ (1973) The effect of ACTH administration on plasma testosterone, dihydrotestosterone and serum LH concentrations in normal men. Steroids 21:553–563PubMedCrossRefGoogle Scholar
  7. Berson SW, Yalow RS (1968) Radioimmunoassay of ACTH in plasma. J Clin Invest 47:2725–2751PubMedCrossRefGoogle Scholar
  8. Besser GM, Edwards CRW (1972) Cushing’s syndrome. In: Mason AS (ed) Clinics in endocrinology and metabolism, vol 1. Saunders, Philadelphia, pp 451–490Google Scholar
  9. Birkenhager JC, Upton GV, Seldenrath HJ, Krieger DT, Tashjian AH, Jr (1976) Medullary thyroid carcinoma: Ectopic production of peptides with ACTH-like, corticotropin-releasing factor-like and prolactin production-stimulating activities. Acta Endocrinol 83:280–292PubMedGoogle Scholar
  10. Brown RD, Van Loon GR, Orth DN, Liddle GW (1973) Cushing’s disease with periodic hormonogenesis: One explanation for paradoxical response to dexamethasone. J Clin Endocrinol Metab 36:445–451PubMedCrossRefGoogle Scholar
  11. Burke CW, Beardwell CG (1973) Cushing’s syndrome: An evaluation of the clinical usefulness of urinary free Cortisol and other urinary steroid measurements in diagnosis. Quart J Med 165:175–204Google Scholar
  12. Callow WH, Callow RK, Emmens CW (1938) Colorimetric determination of substances containing grouping CH2CO in urine extracts as indication of androgen content. Biochem J 32:1312–1331PubMedGoogle Scholar
  13. Carey RM (1980) Suppression of ACTH by Cortisol in dexamethasone-nonsuppressible Cushing’s disease. N Engl J Med 302:275–279PubMedCrossRefGoogle Scholar
  14. Carmalt MHB, Dalton GA, Fletcher RF, Smith WT (1977) The treatment of Cushing’s disease by trans-sphenoidal hypophysectomy. Quart J Med 181:119–134Google Scholar
  15. Carroll BJ (1969) Hypothalamic-pituitary function in depressive illness: Insensitivity to hypo-glycaemia. Br Med J 3:27–28PubMedCrossRefGoogle Scholar
  16. Ceresa F, Boccuzi G, Angeli A, Bisbocci D (1975) Les gluco-corticoides et la secretion des gonadotrophines: Donnes de la pathologie corticosurrenalienne et apres traitment corticoid aigu. Rev Franc Endocrinol Clin 16:283–292Google Scholar
  17. Christy NP, Laragh JH (1961) Pathogenesis of hypokalemic alkalosis in Cushing’s syndrome. N Engl J Med 265:1083–1088PubMedCrossRefGoogle Scholar
  18. Christy NP, Wallace EZ, Jailer JW (1955) Effect of intravenously administered ACTH on plasma 17,21-dihydroxy-20-ketosteroids in normal individuals and in patients with disorders of the adrenal cortex. J Clin Invest 34:899–906PubMedCrossRefGoogle Scholar
  19. Corcoran AC, Page IH (1948) Methods for chemical determination of corticosteroids in urine and plasma. J Lab Clin Med 33:1326–1333PubMedGoogle Scholar
  20. Corrigan DF, Schaaf M, Whaley RA, Czerwinski CL, Earll JM (1977) Selective venous sampling to differentiate ectopic ACTH secretion from pituitary Cushing’s syndrome. N Engl J Med 296:861–862PubMedCrossRefGoogle Scholar
  21. Crane MG, Harris JJ (1966) Desoxycorticosterone secretion rates in hyperadrenocorticism. J Clin Endocrinol 26:1135–1143CrossRefGoogle Scholar
  22. Crapo L (1979) Cushing’s syndrome: A review of diagnostic tests. Metabolism 28:955–977PubMedCrossRefGoogle Scholar
  23. DeLacerda L, Kowarski A, Migeon CJ (1973) Diurnal variation of the metabolic clearance rate of Cortisol. Effect on measurement of Cortisol production rate. J Clin Endocrinol Metab 36:1043–1049CrossRefGoogle Scholar
  24. Demura R, Demura T, Nunohawa T, Baba H, Miura K (1972) Response of plasma ACTH, GH, LH and 11-hydroxycorticosteroids to various stimuli in patients with Cushing’s syndrome. J Clin Endocrinol Metab 34:852–859PubMedCrossRefGoogle Scholar
  25. Doe RP, Vennes JA, Flink EB (1960) Diurnal variation of 17-hydroxycorticosteroids, sodium, potassium, magnesium and creatinine in normal subjects and in cases of treated adrenal insufficiency and Cushing’s syndrome. J Clin Endocrinol 20:253–265CrossRefGoogle Scholar
  26. Duick DS, Wahner HW (1979) Thyroid axis in patients with Cushing’s syndrome. Arch Intern Med 139:767–772PubMedCrossRefGoogle Scholar
  27. Dunnic NR, Schaner EG, Doppman JL, Strott CA, Gill JR, Javadpour N (1979) Computed tomography in adrenal tumors. Am J Roentgenol 132:43–46Google Scholar
  28. Eddy RL, Jones AL, Gilliland PF, Ibarra JD, Thompson JQ, McMurry JR, Jr (1973) Cushing’s syndrome: A prospective study of diagnostic methods. Am J Med 55:621–625PubMedCrossRefGoogle Scholar
  29. Eghrari M, McLoughlin MJ, Rosen IE, St. Louis EL, Wilson SR, Wise DJ, Yeung HPH (1980) The role of computed tomography in assessment of tumoral pathology of the adrenal glands. J Comput Asst Tomog 4:71–77CrossRefGoogle Scholar
  30. Eik-Nes K, Sandberg AA, Migeon CJ, Tyler FH, Samuels LT (1955) Changes in plasma levels of 17-hydroxycorticoids during I.V. administration of ACTH. II. Response under various clinical conditions. J Clin Endocrinol Metab 15:13–21PubMedCrossRefGoogle Scholar
  31. Fehm HL, Voight KH (1979) Pathophysiology of Cushing’s disease. Pathobiol Annu 9:225–255PubMedGoogle Scholar
  32. Fehm HL, Voight KJ, Lang RE, Beinert KE, Kummer GW, Pfeiffer EF (1977) Paradoxical ACTH response to glucocorticoids in Cushing’s disease. N Engl J Med 297:904–907PubMedCrossRefGoogle Scholar
  33. Fellerman H, Dalakos TG, Streeten DHP (1970) Remission of Cushing’s syndrome after unilateral adrenal phlebography. Ann Intern Med 73:585–589PubMedGoogle Scholar
  34. Fitzgerald PA, Newton TH, Tyrrell JB, Aron DC, Wilson CB (1979) Cushing’s disease: Correlation of neuroradiologic studies and surgical results. 61st Meeting Endocrin. Soc., p 133Google Scholar
  35. Freitas JE, Thrall JH, Gross MD, Beirwaltes WH (1978) Adrenal imaging patterns in Cushing’s syndrome. Clin Res 26:305AGoogle Scholar
  36. Gershengorn MC, Arevalo CO, Geras E, Rebecchi MJ (1980) Thyrotropin-releasing hormone stimulation of adrenocorticotropin production by mouse pituitary tumor cells in culture. J Clin Invest 65:1294–1300PubMedCrossRefGoogle Scholar
  37. Gilkes JJH, Rees LH, Besser GM (1977) Plasma immunoreactive corticotrophin and lipotrophin in Cushing’s syndrome and Addison’s disease. Br Med J 1:996–998PubMedCrossRefGoogle Scholar
  38. Gold EM (1979) The Cushing syndromes: Changing views of diagnosis and treatment. Ann Intern Med 90:829–844PubMedGoogle Scholar
  39. Gonzalez-Barcena D, Kastin AJ, Schalch DS, Miller MC, Lee L, Rivas-Llamas R, Schally AV (1974) Response to LH-RH in women before and after treatment with prednisone. Int J Fertil 19:107–110PubMedGoogle Scholar
  40. Hagen K, Kehlet H, Binder C (1978) Diurnal variation in plasma Cortisol and prolactin in patients with Cushing’s syndrome. Acta Endocrinol 88:737–743PubMedGoogle Scholar
  41. Hall R, Besser GM, Schally AV, Coy DH, Evered D, Goldie KJ, Kastin AJ, McNeilly AS, Mortimer CH, Phenekos C, Turnbridge WM, Weightman D (1973) Action of growth-hormone-release inhibitory hormone in healthy men and in acromegaly. Lancet II:581–584CrossRefGoogle Scholar
  42. Harden R McG, Forrest APM (1964) Cushing’s syndrome with atypical biochemical results. Acta Endocrinol 46:256–264PubMedGoogle Scholar
  43. Hashimoto K (1975) The pituitary ACTH, GH, LH, FSH, TSH and prolactin reserves in patients with Cushing’s syndrome. Endocrinol Jpn 22:67–77PubMedCrossRefGoogle Scholar
  44. Holdaway IM, Evans MC, Ibbertson HK (1973) Experience with a short test of pituitary-adrenal function. Aust NZ J Med 3:507–511CrossRefGoogle Scholar
  45. Iannaccone A, Gabrilove JL, Brahms SA, Soffer LJ (1960) The roentgen diagnosis of adrenal tumor in Cushing’s syndrome. Arch Intern Med 105:257–263PubMedCrossRefGoogle Scholar
  46. Irvine WJ, Toft AD, Wilson KS, Fraser R, Wilson A, Young J, Hunter WM, Ismail AAA, Burger PE (1974) The effect of synthetic corticotropin analogues on adrenocortical, anterior pituitary and testicular function. J Clin Endocrinol Metab 39:522–529PubMedCrossRefGoogle Scholar
  47. Jailer JW, Gould JJ, Wallace EZ (1954) Evaluation of “cortisone test” as diagnostic aid in differentiating adrenal hyperplasia from adrenal neoplasia. Am J Med 16:340–345PubMedCrossRefGoogle Scholar
  48. James VHT, London J, Wynn V, Greenwood FC (1968) A fundamental defect of adrenocortical control in Cushing’s disease. J Endocrinol 40:15–28PubMedCrossRefGoogle Scholar
  49. Jubiz W, Meikle SW, West CD, Tyler FH (1970) Single-dose metyrapone test. Arch Intern Med 125:472–474PubMedCrossRefGoogle Scholar
  50. Kahn PC, Nickrosz LV (1967) Selective angiography of the adrenal glands. Am J Roentgenol 101:739–749Google Scholar
  51. Katz J (1966) Failure of dexamethasone suppression in adrenal hyperplasia. Arch Intern Med 118:265–269PubMedCrossRefGoogle Scholar
  52. Kendall JW, Sloop PR Jr (1968) Dexamethasone-suppressive adrenocortical tumor. N Engl J Med 279:532–535PubMedCrossRefGoogle Scholar
  53. Komanicky P, Spark RF, Melby JC (1978) Treatment of Cushing’s syndrome with trilostane (WIN 24, 549), an inhibitor of adrenal steroid biosynthesis. J Clin Endocrinol Metab 47:1042–1051PubMedCrossRefGoogle Scholar
  54. Krieger DT (1979) Plasma ACTH and corticosteroids. In: DeGroot LJ et al. (eds) Textbook of endocrinology, Grune and Stratton, New York, pp 1139–1156Google Scholar
  55. Krieger DT, Allen W, Rizzo F, Krieger HP (1971) Characterization of the normal temporal pattern of plasma corticosteroid levels. J Clin Endocrinol Metab 32:266–284PubMedCrossRefGoogle Scholar
  56. Krieger DT, Gewirtz GP (1974) Recovery of hypothalamic-pituitary-adrenal function, growth hormone responsiveness and sleep EEG pattern in a patient following removal of an adrenal cortical adenoma. J Clin Endocrinol Metab 38:1075–1082PubMedCrossRefGoogle Scholar
  57. Krieger DT, Glick SM (1972) Growth hormone and Cortisol responsiveness in Cushing’s syndrome: Relation to a possible central nervous system etiology. Am J Med 52:25–40PubMedCrossRefGoogle Scholar
  58. Krieger DT, Glick SM (1974) Sleep EEG stages and plasma growth hormone concentration in states of endogenous and exogenous hypercortisolemia on ACTH elevation. J Clin Endocrinol Metab 39:986–1000PubMedCrossRefGoogle Scholar
  59. Krieger DT, Howanitz PJ, Frantz AG (1976) Absence of nocturnal elevation of plasma prolactin concentration in Cushing’s disease. J Clin Endocrinol Metab 42:260–272PubMedCrossRefGoogle Scholar
  60. Krieger DT, Liotta AS, Li CH (1977) Human plasma immunoreactive β-lipotropin: Correlation with basal and stimulated plasma ACTH concentrations. Life Sci 21:1771–1778PubMedCrossRefGoogle Scholar
  61. Krieger DT, Liotta AS, Suda T, Goodgold A, Condon E (1979) Human plasma immunoreactive lipotropin and ACTH in normal subjects and in patients with pituitary-adrenal disease. J Clin Endocrinol Metab 48:566–571PubMedCrossRefGoogle Scholar
  62. Krieger DT, Luria M (1977) Plasma ACTH and Cortisol responses to TRF, vasopressin and hypoglycemia in Cushing’s disease and Nelson’s syndrome. J Clin Endocrinol Metab 44:361–368PubMedCrossRefGoogle Scholar
  63. Krieger DT, Samojlik E, Bardin CW (1978) Cortisol and androgen secretion in a case of Nelson’s syndrome with paratesticular tumors: Response to cyproheptadine therapy. J Clin Endocrinol Metab 47:837–844PubMedCrossRefGoogle Scholar
  64. Laidlaw JC, Jenkins D, Reddy WJ, Harrison JH, Thorn GW (1954) Diagnosis of hyperadreno-corticism. J Clin Endocrinol Metab 14:781 (Abstract)Google Scholar
  65. Lamberts SWJ, deJong FH, Birkenhager JC (1977) Evaluation of diagnostic and differential diagnostic tests in Cushing’s syndrome. Neth J Med 20:267–274PubMedGoogle Scholar
  66. Leach RB, Margulis RR (1965) Inhibition of adrenocortical responsiveness during progestin therapy. Am J Obstet Gynecol 92:762–765PubMedGoogle Scholar
  67. Lecky MW, Wolfman NT, Modic CW (1976) Current concepts of adrenal angiography. Radiol Clin North Am 14:209–252Google Scholar
  68. Liddle GW (1960) Tests of pituitary-adrenal suppressibility in the diagnosis of Cushing’s syndrome. J Clin Endocrinol Metab 20:1539–1559PubMedCrossRefGoogle Scholar
  69. Liddle GW, Estep HL, Kendall JW Jr, Williams WC Jr, Townes AW (1959) Clinical application of a new test of pituitary reserve. J Clin Endocrinol Metab 19:875–894PubMedCrossRefGoogle Scholar
  70. Lieberman LM, Beierwaltes WH, Conn JW, Ansari AN, Nishiyams H (1971) Diagnosis of adrenal disease by visualization of human adrenal glands with 131I-19-iodoeholesterol. N Engl J Med 285:1387–1393PubMedCrossRefGoogle Scholar
  71. Linn JE Jr, Bowdoin B, Farmer TA, Meador CK (1967) Observations and comments on failure of dexamethasone suppression. N Engl J Med 277:403–405PubMedCrossRefGoogle Scholar
  72. Lipscomb H, Nelson DM (1962) A sensitive biological assay for ACTH. Endocrinology 71:13–23PubMedCrossRefGoogle Scholar
  73. Ludecke D, Kautzky R, Saeger W, Schrader D (1976) Selective removal of hypersecreting adenomas? An analysis of endocrine function, operative and microscopical findings in 101 cases. Acta Neurochir (Wien) 35:27–42CrossRefGoogle Scholar
  74. Luton JP, Thieblot P, Valcke C, Mahoudea JA, Bricaire H (1977) Reversible gonadotropin deficiency in male Cushing’s disease. J Clin Endocrinol Metab 45:488–495PubMedCrossRefGoogle Scholar
  75. MacErlean DP, Doyle FH (1976) The pituitary fossa in Cushing’s syndrome: A retrospective analysis of 93 patients. Br J Radiol 49:820–826PubMedCrossRefGoogle Scholar
  76. McKenna TJ, Lorber D, Lacroix A, Rabin D (1979) Testicular activity in Cushing’s disease. Acta Endocrinol 91:501–510PubMedGoogle Scholar
  77. Meikle AW, Lagerquist LG, Tyler FH (1975) Apparently normal pituitary-adrenal suppressibility in Cushing’s syndrome: Dexamethasone metabolism and plasma levels. J Lab Clin Med 86:472–478PubMedGoogle Scholar
  78. Meikle AW, Stanchfield JB, West CD, Tyler FH (1974) Hydrocortisone suppression test for Cushing’s syndrome: Therapy with anticonvulsants. Arch Intern Med 134:1068–1071PubMedCrossRefGoogle Scholar
  79. Miles JM, Wahner HW, Carpenter PC, Salassa RM, Northcutt RC (1979) Adrenal scintiscanning with NP-59, a new radioiodinated cholesterol agent. Mayo Clin Proc 54:321–327PubMedGoogle Scholar
  80. Mitty HA, Nicolis GL, Gabrilove JL (1973) Adrenal venography: Clinical-roentgenographic correlation in 80 patients. Am J Roentgenol 129:564–575Google Scholar
  81. Nichols T, Nugent CA, Tyler FH (1968) Steroid laboratory tests in the diagnosis of Cushing’s syndrome. Am J Med 45:116–128CrossRefGoogle Scholar
  82. Nugent CA, MacDiarmid WD, Nelson AR, Tyler FH (1963) Rate of adrenal Cortisol production in response to maximal stimulation with ACTH. J Clin Endocrinol Metab 23:684–693PubMedCrossRefGoogle Scholar
  83. Nugent CA, Nichols T, Tyler FH (1965) Diagnosis of Cushing’s syndrome: Single-dose dexamethasone suppression test. Arch Intern Med 116:172–176PubMedCrossRefGoogle Scholar
  84. Oki S, Nakai Y, Nakao K, Imura H (1980) Plasma β-endorphin responses to somatostatin, thyrotropin-releasing hormone, or vasopressin in Nelson’s syndrome. J Clin Endocrinol Metab 50:194–197PubMedCrossRefGoogle Scholar
  85. Olsen NJ, Fang VS, DeGroot LJ (1978) Cushing’s syndrome due to adrenal adenoma with persistent diurnal Cortisol secretory rhythm. Metabolism 27:695–700PubMedCrossRefGoogle Scholar
  86. Pavlatos FC, Smilo RP, Forsham PH (1965) A rapid screening test for Cushing’s syndrome. JAMA 193:720–723PubMedCrossRefGoogle Scholar
  87. Pieters GFFM, Smals, AGH, Benraad TJ, Kloppenborg PWC (1979) Plasma Cortisol response to thyrotropin-releasing hormone and luteinizing hormone-releasing hormone in Cushing’s disease. J Clin Endocrinol Metab 48:874–876PubMedCrossRefGoogle Scholar
  88. Porter CC, Silber RH (1950) A quantitative color reaction for cortisone and related 17,21-dihy-droxy-20-ketosteroids. J Biol Chem 185:201–207PubMedGoogle Scholar
  89. Raux MC, Binoux M, Luton JP, Gourmelin M, Girard F (1975) Studies of ACTH secretion control in 116 cases of Cushing’s syndrome. J Clin Endocrinol’Metab 40:186–197CrossRefGoogle Scholar
  90. Rayfield EJ, Rose LI, Cain JP, Dluhy RG, Williams GH (1971) ACTH-responsive, dexamethasone-suppressible adrenocortical carcinoma. N Engl J Med 284:591–592PubMedCrossRefGoogle Scholar
  91. Rees LH, Romlin SJ, Ratter SJ, Jeffcoate WJ, Nichol W (1978) ACTH/lipotropin (LPH) measurements in the localization of ectopic ACTH-secreting tumours. 60th Meeting. Endocrin. Soc., pl97Google Scholar
  92. Rivarola MA, Saez JM, Meyers WJ, Jenkins ME, Migeon CJ (1966) Metabolic clearance rate and blood production rate of testosterone and androst-4-ene 3, 17-dione under basal conditions, ACTH and hCG stimulation: Comparison with urinary production rate of testosterone. J Clin Endocrinol Metab 26:1208–1218PubMedCrossRefGoogle Scholar
  93. Rovit RL, Duane TD (1969) Cushing’s syndrome and pituitary tumors: Pathophysiology and ocular manifestations of ACTH-secreting pituitary adenomas. Am J Med 46:416–427PubMedCrossRefGoogle Scholar
  94. Sakar SD, Cohen EL, Beierwaltes WH, Ice RD, Cooper R, Gold EN (1977) A new and superior adrenal imaging agent, 131I-6β-iodomethyl-19-nor-cholesterol (NP-59): Evaluation in humans. J Clin Endocrinol Metab 45:353–362CrossRefGoogle Scholar
  95. Salassa RM, Kearns TP, Hernohan JW, Sprague RG, MacCarty CS (1959) Pituitary tumors in patients with Cushing’s syndrome. J Clin Endocrinol Metab 19:1523–1539PubMedCrossRefGoogle Scholar
  96. Salassa RM, Laws ER Jr, Carpenter PC, Northcutt RC (1978) Transsphenoidal removal of pituitary microadenoma in Cushing’s disease. Mayo Clin Proc 53:24–28PubMedGoogle Scholar
  97. Schambelan M, Slaton PE Jr, Biglieri EG (1971) Mineralocorticoid production in hyperadreno-corticism: Role in pathogenesis of hypokalemia alkalosis. Am J Med 51:299–303PubMedCrossRefGoogle Scholar
  98. Schteingart DE, Conn JW, Lieberman LM, Beierwaltes WJ (1972) Persistent or recurrent Cushing’s syndrome after “total” adrenalectomy. Arch Intern Med 130:384–387PubMedCrossRefGoogle Scholar
  99. Seabold JE, Bernardino ME, Goldstein HM, Green B, Glenn HJ, Haynie TP (1978) Comparison of adrenal scintigraphy, ultrasonography and computerized tomography in the evaluation of suspected adrenal lesions (abstract). Int J Nucl Med Biol 5:202–203Google Scholar
  100. Sederberg-Olsen P, Binder C, Kehlet H, Neville AM, Nielsen LM (1973) Episodic variation in plasma corticosteroids in subjects with Cushing’s syndrome of differing etiology. J Clin Endocrinol Metab 36:906–910PubMedCrossRefGoogle Scholar
  101. Silverman SR, Marnell RT, Sholiton LJ, Werk EE Jr (1963) Failure of dexamethasone suppression test to indicate bilateral adrenocortical hyperplasia in Cushing’s syndrome. J Clin Endocrinol Metab 23:167–172PubMedCrossRefGoogle Scholar
  102. Smals AGH, Kloppenborg PWC, Benraad TJ (1977) Plasma testosterone profiles in Cushing’s syndrome. J Clin Endocrinol Metab 45:240–245PubMedCrossRefGoogle Scholar
  103. Spiger M, Jubiz W, Meikle AW, West CD, Tyler FH (1975) Single-dose metyrapone test. Arch Intern Med 135:698–700PubMedCrossRefGoogle Scholar
  104. Staub JJ, Girard J, Noelpp B, Baumann JB, Graf S, Ratcliffe JG (1979) The short metyrapone test: Comparison of the plasma ACTH response to metyrapone and insulin-induced hypo-glycaemia. Clin Endocrinol 10:595–602CrossRefGoogle Scholar
  105. Streeten DHP, Stevenson CT, Dalakos TG, Nicholas JJ, Dennick LG, Fellerman H (1969) The diagnosis of hypercortisolism. Biochemical criteria differentiating patients from lean and obese normal subjects and from females on oral contraceptives. J Clin Endocrinol Metab 29:1191–1211PubMedCrossRefGoogle Scholar
  106. Suda T, Liotta AS, Krieger DT (1978) β-Endorphin is not detectable in plasma from normal subjects. Science 202:221–223PubMedCrossRefGoogle Scholar
  107. Swanson HA, du Boulay G (1975) Borderline variants of the normal pituitary fossa. Br J Radiol 48:366–369PubMedCrossRefGoogle Scholar
  108. Tyrrell JB, Brooks RM, Fitzgerald PA, Cofoid PB, Forsham PH, Wilson CB (1978) Cushing’s disease: Selective trans-sphenoidal resection of pituitary microadenomas. N Engl J Med 298:753–758PubMedCrossRefGoogle Scholar
  109. Tyrrell JB, Lorenzi M, Forsham PH, Gerich JE (1975) The effect of somatostatin on secretion of adrenocorticotropin in normal subjects and in patients with Nelson’s syndrome and Cushing’s disease. 57th Meeting Endocrin. Soc., p 350Google Scholar
  110. Tyrrell JB, Wiener-Kronish J, Lorenzi M, Brooks RM, Forsham PH (1977) Cushing’s disease: Growth hormone response to hypoglycemia after correction of hypercortisolism J Clin Endocrinol Metab 44:218–221PubMedCrossRefGoogle Scholar
  111. Vagnucci AH (1979) Analysis of circadian periodicity of plasma Cortisol in normal man and in Cushing’s syndrome. Am J Physiol 236:R268–R281PubMedGoogle Scholar
  112. Van Cauter E, Huyberechts R (1973) Problems in the statistical analysis of biological time series: The cosinor test and the periodogram. J Interdiscip Cycle Res 4:41–57CrossRefGoogle Scholar
  113. Van Cauter EV, Leclercq R, Vanhaelst L, Golstein J (1974) Simultaneous study of Cortisol and TSH daily variations in normal subjects and patients with hyperadrenalcorticism. J Clin Endocrinol Metab 39:645–652PubMedCrossRefGoogle Scholar
  114. Weinstein M, Tyrrell B, Newton TH (1976) The sella turcica in Nelson’s syndrome. Radiology 118:363–365PubMedGoogle Scholar
  115. Welbourn RB, Montgomery DAD, Kennedy TL (1971) The natural history of treated Cushing’s syndrome. Br J Surg 58:1–16PubMedCrossRefGoogle Scholar
  116. West CD, Dolman LI (1977) Plasma ACTH radioimmunoassays in the diagnosis of pituitary-adrenal dysfunction. In: Krieger DT, Ganong WF (eds) ACTH and related peptides: Structure, regulation and action. N.Y.Acad. Sci., New York, pp 205–217Google Scholar
  117. West CD, Meikle AW (1979) Laboratory tests for the diagnosis of Cushing’s syndrome in adrenal insufficiency and factors affecting those tests. In: DeGroot LJ et al. (eds) Endocrinology, vol. 2. Grune and Stratton, New YorkGoogle Scholar
  118. West CD, Meikle AW, Ganguly A, Stanchfield JB, Atcheson JB, Tyler FH (1979) Multiple steroid abnormalities in Cushing’s syndrome. 61st Meeting Endocrin. Soc., p235Google Scholar
  119. Wiedemann E, Saito T, Linfoot JA (1978) Independent regulation of plasma beta-lipotropin and ACTH in patients with Cushing’s disease and acromegaly (abstract). Clin Res 26:108AGoogle Scholar
  120. Yalow RS, Berson SA (1973) Characteristics of “big ACTH” in human plasma and pituitary extracts. J Clin Endocrinol Metab 36:415–423PubMedCrossRefGoogle Scholar
  121. Yalow RS, Glick SM, Roth J, Berson SA (1964) Radioimmunoassay of human plasma ACTH. J Clin Endocrinol Metab 24:1219–1225PubMedCrossRefGoogle Scholar
  122. Yamaguchi H, Liotta AS, Krieger DT (1980) Simultaneous determination of human plasma immunoreactive β-lipotropin, γ-lipotropin, and β-endorphin utilizing immune-affinity chromatography. J Clin Endocrinol Metab 51:1002–1008PubMedCrossRefGoogle Scholar
  123. Yeh H-C, Mitty HA, Rose J, Wolf BS, Gabrilove JL (1978) Ultrasonography of adrenal masses: Usual features. Radiology 127:467–474PubMedGoogle Scholar
  124. Yoshida K, Satowa H, Sato A, Ichikawa Y, Kream J, Levin J, Zumoff B, Hellman L, Fukushima DK (1979) Plasma Cortisol profiles in Cushing’s syndrome. Acta Endocrinol 91:319–328PubMedGoogle Scholar
  125. Zimmerman CE, Eisenberg H, Spark R, Rosoff CB (1974) Transvenous adrenal destruction: Clinical trials in patients with metastatic malignancy. Surgery 75:550–556PubMedGoogle Scholar
  126. Zumoff B, Fukushima DK, Weitzman ED, Kream J, Hellman L (1974) The sex difference in plasma Cortisol concentration in man. J Clin Endocrinol Metab 39:805–808PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin, Heidelberg 1982

Authors and Affiliations

  • Dorothy T. Krieger
    • 1
  1. 1.Division of EndocrinologyThe Mount Sinai Medical CenterNew YorkUSA

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