Differential Diagnosis
Pituitary cause for Cushing syndrome
Adrenal cause for Cushing syndrome
Ectopic ACTH secretion as a cause for Cushing syndrome
One of many conditions that produce a high cortisol level wtihout manifestations of Cushing syndrome
Suggested Additional Lab Testing
Pituitary Cushing syndrome
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No ACTH suppression and, therefore, no cortisol suppression in the dexamethasone suppression test
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Plasma ACTH elevated or occasionally normal
Adrenal Cushing syndrome
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No ACTH suppression with dexamethasone suppression
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Low plasma ACTH
Ectopic ACTH secretion producing Cushing syndrome
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No ACTH suppression in the dexamethasone suppression test
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For ectopic ACTH-secreting tumors, ACTH elevated, often at higher levels than found in Cushing disease from a pituitary cause
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