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Exp Clin Endocrinol Diabetes 2020; 128(10): 667-671
DOI: 10.1055/a-1017-3217
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Factors Affecting Dexamethasone Suppression Test Results

A. Berlińska
1   Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
,
R. Świątkowska-Stodulska
1   Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
,
K Sworczak
1   Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Abstract

Dexamethasone suppression tests are basic tools in diagnostics of hypercortisolemia. Low-dose tests play major role in screening and initial assessment. High-dose tests are aimed at more elaborate diagnostics, however their clinical value is questionable. Dexamethasone is a highly potent, synthetic steroid. It is metabolized by cytochrome P450 3A4 (CYP3A4), and so are various other xenobiotics. Due to wide spectrum of substances processed by CYP3A4, interferences and interactions are not uncommon. Physicians should be familiar with drugs modifying dexamethasone metabolism, and therefore the results of dynamic tests. Other important concerns are: drugs enhancing cortisol-binding globulin production, organ dysfunction, pseudo-Cushing states, pregnancy and other physiological conditions leading to elevated blood cortisol, cyclic Cushing disease. To properly assess and assist patients, it is crucial for health professionals to understand and be able to overcome such clinical dilemmas.

Key words

hypercortisolemia - Cushing’s syndrome - glucocorticoids - dexamethasone - dexamethasone suppression test - hormonal testing

Supplementary Material



Publication History

Received: 02 July 2019
Received: 27 August 2019

Accepted: 23 September 2019

Article published online:
25 October 2019

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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