Dexamethasone suppression tests
INTRODUCTION
Dexamethasone suppression tests (DSTs) are primarily used to screen for excess cortisol production (Cushing syndrome) and are useful in detecting dysregulated cortisol hypersecretion in adrenal incidentalomas. DSTs are less reliable for the evaluation of the differential diagnosis of corticotropin (ACTH)-dependent Cushing syndrome. Dexamethasone is approximately 30 to 40 times more potent than cortisol and has no appreciable mineralocorticoid activity. The DSTs assess the hypothalamic and pituitary corticotroph cell responses to glucocorticoid negative feedback inhibition of corticotropin-releasing hormone (CRH) and ACTH secretion.This topic will review the basic principles of the DSTs. Additional information on when to choose them to determine the diagnosis and the cause of Cushing syndrome is discussed separately.
●(See "Establishing the diagnosis of Cushing syndrome".)
●(See "Establishing the cause of Cushing syndrome".)
●(See "Evaluation and management of the adrenal incidentaloma".)
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