Incidentaloma laboratory findings: Difference between revisions

	Incidentaloma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Incidentaloma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Incidentaloma laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Incidentaloma laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Incidentaloma laboratory findings
CDC on Incidentaloma laboratory findings
Incidentaloma laboratory findings in the news
Blogs on Incidentaloma laboratory findings
Directions to Hospitals Treating Psoriasis
Risk calculators and risk factors for Incidentaloma laboratory findings

VisualWikitext

Revision as of 19:20, 28 August 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Laboratory findings consistent with the diagnosis of incidentaloma include an abnormal 1 mg overnight dexamethasone for subclinical Cushing's syndrome that should be confirmed with 24-hour urinary free cortisol, serum ACTH concentration, and dehydroepiandrosterone sulfate (DHEAS). In patients with adrenal masses that have a probability for pheochromocytoma, routine measurement of 24-hour urinary fractionated metanephrines and catecholamines should be done. All patients with hypertension and an adrenal incidentaloma should be evaluated by measurements of plasma aldosterone concentration and plasma renin activity.

Laboratory Findings

Subclinical Cushing's syndrome

Subclinical Cushing's syndrome should be ruled out by performing the 1 mg overnight dexamethasone suppression test (DST).
An abnormal 1 mg overnight dexamethasone should be confirmed with 24-hour urinary free cortisol, serum ACTH concentration, and dehydroepiandrosterone sulfate (DHEAS).

An undetectable level of serum ACTH is also supportive of the diagnosis of subclinical Cushing’s syndrome.

Hormonal evaluation in the patients with subclinical Cushing's syndrome showed the following [11]:

Low baseline secretion of ACTH
Lack of suppressibility of cortisol secretion after 1 mg dexamethasone
Supranormal 24-hour urinary cortisol excretion
Disturbed cortisol circadian rhythm
Blunted plasma ACTH responses to corticotropin-releasing hormone (CRH)

Pheochromocytoma

In patients with adrenal masses that have a probability for pheochromocytoma, routine measurement of 24-hour urinary fractionated metanephrines and catecholamines should be done.

Aldosteronomas

All patients with hypertension and an adrenal incidentaloma should be evaluated by measurements of plasma aldosterone concentration and plasma renin activity.

References

Template:WH Template:WS

@@ Line 5: / Line 5: @@
 ==Overview==
-Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
+Laboratory findings consistent with the diagnosis of incidentaloma include an abnormal 1 mg overnight dexamethasone for subclinical Cushing's syndrome that should be confirmed with 24-hour urinary free cortisol, serum ACTH concentration, and dehydroepiandrosterone sulfate (DHEAS). In patients with adrenal masses that have a probability for pheochromocytoma, routine measurement of 24-hour urinary fractionated metanephrines and catecholamines should be done. All patients with hypertension and an adrenal incidentaloma should be evaluated by measurements of plasma aldosterone concentration and plasma renin activity.
-[Test] is usually normal among patients with [disease name].
+==Laboratory Findings==
+=== Subclinical Cushing's syndrome ===
+*Subclinical Cushing's syndrome should be ruled out by performing the 1 mg overnight dexamethasone suppression test (DST).
+*An abnormal 1 mg overnight dexamethasone should be confirmed with 24-hour urinary free cortisol, serum ACTH concentration, and dehydroepiandrosterone sulfate (DHEAS).
+* An undetectable level of serum ACTH is also supportive of the diagnosis of subclinical Cushing’s syndrome.
-==Laboratory Findings==
+* Hormonal evaluation in the patients with subclinical Cushing's syndrome showed the following [11]:
-*An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
-*[Test] is usually normal among patients with [disease name].
+* Low baseline secretion of ACTH
-*Laboratory findings consistent with the diagnosis of [disease name] include
+* Lack of suppressibility of cortisol secretion after 1 mg dexamethasone
-**[Abnormal test 1]
+* Supranormal 24-hour urinary cortisol excretion
-**[Abnormal test 2]
+* Disturbed cortisol circadian rhythm
-**[Abnormal test 3]
+* Blunted plasma ACTH responses to corticotropin-releasing hormone (CRH)
+=== Pheochromocytoma ===
+In patients with adrenal masses that have a probability for pheochromocytoma, routine measurement of 24-hour urinary fractionated metanephrines and catecholamines should be done.
+=== '''Aldosteronomas''' ===
+All patients with hypertension and an adrenal incidentaloma should be evaluated by measurements of plasma aldosterone concentration and plasma renin activity.
 ==References==