Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

• Published in: European journal of endocrinology Vol. 168; no. 3; pp. 379 - 384
• Main Authors: Karaca, Z, Acmaz, B, Acmaz, G, Tanriverdi, F, Unluhizarci, K, Aribas, S, Sahin, Y, Kelestimur, F
• Format: Journal Article
• Language: English
• Published: Bristol BioScientifica 01-03-2013
• Subjects: Adolescent; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Adult; Biological and medical sciences; Clinical Study; Cushing Syndrome - diagnosis; Cushing Syndrome - epidemiology; Cushing Syndrome - physiopathology; Dexamethasone; Endocrinopathies; Female; Follicular Phase - blood; Fundamental and applied biological sciences. Psychology; Glucocorticoids; Hirsutism - blood; Hirsutism - diagnosis; Hirsutism - etiology; Hirsutism - pathology; Humans; Hydrocortisone - blood; Hyperandrogenism - diagnosis; Hyperandrogenism - epidemiology; Hyperandrogenism - physiopathology; Hyperplasia; Medical sciences; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Outpatient Clinics, Hospital; Ovarian Function Tests; Ovary - drug effects; Ovary - pathology; Ovary - physiopathology; Polycystic Ovary Syndrome - diagnosis; Polycystic Ovary Syndrome - epidemiology; Polycystic Ovary Syndrome - physiopathology; Prevalence; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Tertiary Care Centers; Turkey - epidemiology; Vertebrates: endocrinology; Young Adult; Turkey; Endocrinopathy; Human; Hair; Skin disease; Adrenal cortex diseases; Hirsutism; Cushing syndrome; Patient; Hyperadrenocorticism; Medical screening; Masculinization; Adrenal gland diseases; Endocrinology
• ISSN: 0804-4643; 1479-683X
• DOI: 10.1530/EJE-12-0938

ContextPrevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known.ObjectiveScreening of CS in patients with hirsutism.SettingReferral hospital.Patients and other participantsThis study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism.InterventionAll the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS.Main outcome measureResponse to LDDST in patients presenting with hirsutism.ResultsAll the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients.ConclusionRoutine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.