Titre:	Recommendations of the neuroendocrinology department of the Brazilian society of endocrinology and metabolism for the diagnosis of Cushing’s disease in Brazil
Auteur(s):	Machado, Márcio Carlos Fragoso, Maria Candida Barisson Vilares Moreira, Ayrton Custódio Boguszewski, César Luiz Vieira Neto, Leonardo Naves, Luciana Ansaneli Vilar, Lucio Araújo, Luiz Antônio de Czepielewski, Mauro Antonio Gadelha, Monica R. Musolino, Nina Rosa Castro Miranda, Paulo Augusto Carvalho Bronstein, Marcello Delano Oliveira Júnior, Antônio Ribeiro
Assunto::	Cushing, Doença de - diagnóstico Síndrome de Cushing
Date de publication:	jui-2016
Editeur:	Sociedade Brasileira de Endocrinologia e Metabologia
Référence bibliographique:	MACHADO, Márcio Carlos et al. Recommendations of the neuroendocrinology department of the Brazilian society of endocrinology and metabolism for the diagnosis of Cushing’s disease in Brazil. Archives of Endocrinology and Metabolism, São Paulo, v. 60, n. 3, p. 267-286, jun. 2016. Disponível em: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000300267&lng=en&nrm=iso>. Acesso em: 11 dez. 2017. doi: http://dx.doi.org/10.1590/2359-3997000000174.
Abstract:	Although it is a rare condition, the accurate diagnosis and treatment of Cushing’s disease is important due to its higher morbidity and mortality compared to the general population, which is attributed to cardiovascular diseases, diabetes mellitus and infections. Screening for hypercortisolism is recommended for patients who present multiple and progressive clinical signs and symptoms, especially those who are considered to be more specific to Cushing’s syndrome, abnormal findings relative to age (e.g., spinal osteoporosis and high blood pressure in young patients), weight gain associated with reduced growth rate in the pediatric population and for those with adrenal incidentalomas. Routine screening is not recommended for other groups of patients, such as those with obesity or diabetes mellitus. Magnetic resonance imaging (MRI) of the pituitary, the corticotropin-releasing hormone (CRH) test and the high-dose dexamethasone suppression test are the main tests for the differential diagnosis of ACTH-dependent Cushing’s syndrome. Bilateral and simultaneous petrosal sinus sampling is the gold standard method and is performed when the triad of initial tests is inconclusive, doubtful or conflicting. The aim of this article is to provide information on the early detection and establishment of a proper diagnosis of Cushing’s disease, recommending follow-up of these patients at experienced referral centers.
metadata.dc.description.unidade:	Faculdade de Medicina (FMD)
Licença::	Archives of Endocrinology and Metabolism - This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0). Fonte: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972016000300267&lng=en&nrm=iso. Acesso em: 11 dez. 2017.
DOI:	http://dx.doi.org/10.1590/2359-3997000000174
Collection(s) :	Artigos publicados em periódicos e afins

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