Elevated 24-Hour Urine Free Cortisol
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
No ACTH suppression and, therefore, no cortisol suppression in the dexamethasone suppression test
Plasma ACTH elevated or occasionally normal
Adrenal Cushing syndrome
No ACTH suppression with dexamethasone suppression
Low plasma ACTH
Ectopic ACTH secretion producing Cushing syndrome
No ACTH suppression in the dexamethasone suppression test
For ectopic ACTH-secreting tumors, ACTH elevated, often at higher levels than found in Cushing disease from a pituitary cause
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