Clinical Chemistry
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Clinical Chemistry 35: 2216-2219, 1989;
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Clinical Chemistry, Vol 35, 2216-2219, Copyright © 1989 by American Association for Clinical Chemistry

Decreased dehydroepiandrosterone sulfate in pigmented nodular adrenal dysplasia

SS Braithwaite, S Collins, RA Prinz, JL Walloch and GL Winters
Department of Medicine, Loyola University Stritch School of Medicine, Maywood, IL 60153.

Previous reports on patients with endogenous Cushing's syndrome describe low concentrations of the adrenal androgen dehydroepiandrosterone sulfate (DHEA-S) in adrenal adenoma and in a case of feminizing macronodular hyperplasia. Here we present hormonal data from two adult sisters with Cushing's syndrome as a result of pigmented nodular adrenal dysplasia. Corticotropin concentrations were in the mid-normal range, cortisol production was unaffected by administration of dexamethasone (8 mg/24 h), and baseline concentrations of DHEA-S were less than 0.5 mumol/L. A low concentration of DHEA-S in these and other previously reported patients with Cushing's syndrome correctly predicts the results of dynamic testing. Decreased DHEA-S in a patient with endogenous Cushing's syndrome can be ascertained by assay of a single sample and should prompt consideration of the diagnosis of autonomous bilateral nodular disease as well as adrenal adenoma.




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Copyright © 1989 by the American Association for Clinical Chemistry.