29:
280:
A normal result is a decrease in cortisol levels upon administration of low-dose dexamethasone. Results indicative of
Cushing's disease involve no change in cortisol on low-dose dexamethasone, but inhibition of cortisol on high-dose dexamethasone. If the cortisol levels are unchanged by low- and
271:
A low dose of dexamethasone suppresses cortisol in individuals with no pathology in endogenous cortisol production. A high dose of dexamethasone exerts negative feedback on pituitary neoplastic ACTH-producing cells (Cushing's disease), but not on ectopic ACTH-producing cells or adrenal adenoma
267:
Low-dose and high-dose variations of the test exist. The test is given at low (usually 1–2 mg) and high (8 mg) doses of dexamethasone, and the levels of cortisol are measured to obtain the results.
281:
high-dose dexamethasone, then other causes of
Cushing's syndrome must be considered with further work-up necessary. After the high-dose dexamethasone, it may be possible to make further interpretations.
448:
Cole MA, Kim PJ, Kalman BA, Spencer RL (February 2000). "Dexamethasone suppression of corticosteroid secretion: evaluation of the site of action by receptor measures and functional studies".
197:
The DST was historically used for diagnosing depression, but by 1988 it was considered to be "at best, severely limited in its clinical ability" for this purpose.
248:- This involves giving an oral dose of dexamethasone at six-hourly intervals for 2 days, with the cortisol level measured 6 hours after the final dose was given
616:
682:
493:"Discriminatory value of the low-dose dexamethasone suppression test in establishing the diagnosis and differential diagnosis of Cushing's syndrome"
589:
Theodore C. Friedman, M.D., Ph.D. Professor of
Medicine-UCLA Chairman, Department of Internal Medicine Charles R. Drew University (2013).
336:
is likely. If an adrenal tumor is not apparent, a chest CT and abdominal CT is indicated to rule out a different tumor secreting ACTH.
814:
609:
242:- An oral dose of dexamethasone is given between 11pm and midnight, and the cortisol level is measured at 8 - 9am the next morning
119:
322:
should be considered because the pituitary still retains some feedback control. A pituitary MRI would be needed to confirm.
652:
602:
577:
568:
Longo, Dan L.; Fauci, Anthony S.; Kasper, Dennis L.; Hauser, Stephen L.; Jameson, J. Larry; Loscalzo, Joseph (2012),
353:
346:
715:
558:
Kumar, Abbas, Fausto. Robbins and Cotran
Pathologic Basis of Disease, 7th ed. Elsevier-Saunders; New York, 2005
156:
114:
77:
809:
411:"How to evaluate a diagnostic marker test. Lessons from the rise and fall of dexamethasone suppression test"
492:
210:
82:
763:
720:
646:
594:
677:
218:
770:
590:
758:
349:
333:
305:
191:
725:
319:
8:
59:
473:
461:
707:
626:
573:
541:
514:
465:
430:
426:
384:
477:
630:
504:
457:
422:
664:
206:
533:
376:
308:, not disease (i.e., the hypercortisolism is not driven by ACTH hypersecretion)
672:
214:
129:
803:
745:
737:
702:
205:
Dexamethasone is an exogenous steroid that provides negative feedback to the
187:
179:
33:
788:
780:
545:
518:
509:
469:
388:
434:
410:
28:
124:
87:
624:
638:
183:
694:
491:
Isidori AM, Kaltsas GA, Mohammed S, et al. (November 2003).
217:
receptors in the anterior pituitary gland, which lie outside the
532:
Johnson, Donavon B.; Lopez, Michael J.; Kelley, Brendan (2020).
313:
is not suppressed by low doses, but is suppressed by high doses
186:
levels change in response to oral doses or an injection of
572:(18th ed.), McGraw Hill Medical, pp. 2897–2898,
567:
490:
447:
408:
375:Dogra, Prerna; Vijayashankar, Narasimha P. (2020).
342:†ACTH as measured prior to dosing of dexamethasone
683:Combined rapid anterior pituitary evaluation panel
531:
374:
801:
610:
213:(ACTH). Specifically, dexamethasone binds to
484:
441:
229:There are several types of DST procedures:
617:
603:
570:Harrison's Principles of Internal Medicine
402:
345:Equivocal results should be followed by a
27:
508:
327:is not suppressed by high or low doses
316:Normal to elevated but not in hundreds
298:is not suppressed by low or high doses
802:
370:
368:
221:, resulting in regulatory modulation.
598:
409:Nierenberg AA, Feinstein AR (1988).
304:Primary hypercortisolism is likely;
55:
365:
190:. It is typically used to diagnose
13:
224:
14:
826:
262:
815:Dynamic endocrine function tests
427:10.1001/jama.1988.03720110061036
377:"Dexamethasone Suppression Test"
354:inferior petrosal sinus sampling
347:corticotropin-releasing hormone
52:proopiomelanocortin derivatives
754:Dexamethasone suppression test
716:Radioactive iodine uptake test
561:
552:
525:
172:dexamethasone suppression test
22:Dexamethasone suppression test
1:
462:10.1016/S0306-4530(99)00045-1
359:
209:to suppress the secretion of
200:
44:assess adrenal gland function
7:
653:digestive system procedures
211:adrenocorticotropic hormone
10:
831:
764:Captopril suppression test
721:Sestamibi parathyroid scan
647:Islet cell transplantation
497:J. Clin. Endocrinol. Metab
182:function by measuring how
58:
779:
736:
693:
663:
637:
540:. StatPearls Publishing.
383:. StatPearls Publishing.
149:
135:
123:
102:
86:
81:
71:
68:
40:
26:
21:
450:Psychoneuroendocrinology
678:Transsphenoidal surgery
275:
771:Fluid deprivation test
510:10.1210/jc.2003-030510
272:(Cushing's syndrome).
257:Dexamethasone-CRT test
759:ACTH stimulation test
334:Ectopic ACTH syndrome
330:Elevated in hundreds
810:Endocrine procedures
726:TRH stimulation test
301:Undetectable or low
178:) is used to assess
219:blood–brain barrier
306:Cushing's syndrome
192:Cushing's syndrome
797:
796:
708:Parathyroidectomy
340:
339:
320:Cushing's disease
165:
164:
48:
47:
822:
631:endocrine system
619:
612:
605:
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583:
582:
579:978-0-07174889-6
565:
559:
556:
550:
549:
529:
523:
522:
512:
503:(11): 5299–306.
488:
482:
481:
445:
439:
438:
421:(11): 1699–702.
406:
400:
399:
397:
395:
372:
350:stimulation test
284:
283:
56:
31:
19:
18:
830:
829:
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823:
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819:
800:
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732:
689:
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633:
623:
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562:
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534:"Dexamethasone"
530:
526:
489:
485:
446:
442:
407:
403:
393:
391:
373:
366:
362:
293:Interpretation
278:
265:
252:Intravenous DST
227:
225:Test procedures
207:pituitary gland
203:
168:
167:
166:
53:
36:
17:
12:
11:
5:
828:
818:
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812:
795:
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792:
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783:
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748:
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730:
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728:
723:
718:
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705:
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690:
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687:
686:
685:
675:
673:Hypophysectomy
669:
667:
661:
660:
658:
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643:
641:
635:
634:
629:involving the
622:
621:
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584:
578:
560:
551:
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483:
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302:
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288:
277:
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263:Interpretation
261:
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259:
254:
249:
243:
226:
223:
215:glucocorticoid
202:
199:
163:
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127:
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108:
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98:
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63:
62:
54:
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50:
49:
46:
45:
42:
38:
37:
32:
24:
23:
15:
9:
6:
4:
3:
2:
827:
816:
813:
811:
808:
807:
805:
790:
787:
786:
784:
782:
778:
772:
769:
765:
762:
760:
757:
755:
752:
751:
749:
747:
746:Adrenalectomy
744:
743:
741:
739:
738:Adrenal gland
735:
727:
724:
722:
719:
717:
714:
713:
711:
709:
706:
704:
703:Thyroidectomy
701:
700:
698:
696:
692:
684:
681:
680:
679:
676:
674:
671:
670:
668:
666:
662:
654:
650:
649:
648:
645:
644:
642:
640:
636:
632:
628:
620:
615:
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608:
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601:
600:
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591:
588:
587:
581:
575:
571:
564:
555:
547:
543:
539:
535:
528:
520:
516:
511:
506:
502:
498:
494:
487:
479:
475:
471:
467:
463:
459:
456:(2): 151–67.
455:
451:
444:
436:
432:
428:
424:
420:
416:
412:
405:
390:
386:
382:
378:
371:
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292:
289:
286:
285:
282:
273:
269:
258:
255:
253:
250:
247:
244:
241:
237:
236:Overnight DST
234:
233:
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230:
222:
220:
216:
212:
208:
198:
195:
193:
189:
188:dexamethasone
185:
181:
180:adrenal gland
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75:
65:
64:
61:
57:
43:
39:
35:
34:Dexamethasone
30:
25:
20:
789:Pinealectomy
781:Pineal gland
753:
569:
563:
554:
537:
527:
500:
496:
486:
453:
449:
443:
418:
414:
404:
392:. Retrieved
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228:
204:
196:
175:
171:
169:
125:γ-lipotropin
88:β-lipotropin
16:Medical test
394:26 December
246:Two-day DST
130:β-endorphin
804:Categories
627:procedures
538:StatPearls
381:StatPearls
360:References
201:Physiology
665:Pituitary
651:see also
625:Test and
287:Cortisol
639:Pancreas
546:29489240
519:14602765
478:17445446
470:10674279
389:31194457
184:cortisol
695:Thyroid
435:3278149
352:, with
41:Purpose
750:Tests
712:Tests
576:
544:
517:
476:
468:
433:
387:
290:ACTH†
161:
153:
150:
145:
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136:
111:
106:
103:
100:
97:
94:
72:
69:
66:
474:S2CID
240:ONDST
157:β-MSH
115:α-MSH
78:γ-MSH
574:ISBN
542:PMID
515:PMID
466:PMID
431:PMID
415:JAMA
396:2020
385:PMID
276:Dose
170:The
120:CLIP
83:ACTH
60:POMC
505:doi
458:doi
423:doi
419:259
238:or
176:DST
806::
536:.
513:.
501:88
499:.
495:.
472:.
464:.
454:25
452:.
429:.
417:.
413:.
379:.
367:^
356:.
194:.
618:e
611:t
604:v
548:.
521:.
507::
480:.
460::
437:.
425::
398:.
174:(
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