Cyclic Cushing's Syndrome - A Diagnostic Challenge

• Published in: Frontiers in endocrinology (Lausanne) Vol. 12; p. 658429
• Main Authors: Świątkowska-Stodulska, Renata, Berlińska, Agata, Stefańska, Katarzyna, Kłosowski, Przemysław, Sworczak, Krzysztof
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 22.04.2021
• Subjects: Animals; Cushing Syndrome - diagnosis; Cushing Syndrome - metabolism; cyclic Cushing’s syndrome; cyclic hypercortisolemia; DDAVP test; desmopressin test; diagnosis of Cushing’s syndrome; Endocrinology; Hair - chemistry; Hair - metabolism; hair cortisol; Humans; Hydrocortisone - chemistry; Hydrocortisone - metabolism; diagnosis of Cushing’s syndrome; cyclic Cushing’s syndrome; hair cortisol; DDAVP test; cyclic hypercortisolemia; desmopressin test
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2021.658429

Cyclic Cushing's syndrome (also known as intermittent or periodic) is a disease characterized by periods of transient hypercortisolemia shifting into periods of normo- and/or hypocortisolemia. Diagnosis of cyclic Cushing's syndrome is based on at least three periods of confirmed hypercortisolemia interspersed by two periods of normocortisolemia. Cyclic Cushing's syndrome is one of the greatest challenges in modern endocrinology due to its diverse clinical picture, unpredictable duration and frequency of phases, and various etiologies. We discuss a diagnostic algorithm for periodic hypercortisolemia with special regard to hair cortisol analysis and desmopressin stimulation test which both seem to be helpful in finding the correct answer.