Steroid Profiling in the Differential Diagnosis of Cushing's Syndrome and Diagnosis of MACS

Abstract

Abstract Background Cushing's Syndrome (CS) is the consequence of the exposure of tissues to extremely high levels of glucocorticoids. Early diagnosis and treatment are the mainstay of optimizing patient outcomes and improving their quality of life. In the recent years steroid profiling by LC-MS sheds more light on the diagnosis of CS. Materials and methods This was a retrospective cross-sectional study. Objective To investigate serum steroid precursor differences between different etiological forms of CS and to suggest a steroid panel for the diagnosis of MACS in patients with adrenal incidentalomas. Results Our studied patients with CD had significantly lower levels of 11-deoxycorticosterone (p = 0.047) and 17 OH progesterone (p = 0.024) compared to those with adrenal forms of CS. In out cohort of patients with adrenal incidentalomas, those with MACS had significantly lower levels of androgens (DHEA, p = 0.001) and cortisone (p = 0.015) and higher levels of 11-deoxycortisol (p = 0.039) compared to the patients with non-secreting adenomas (NSA). Conclusion Introducing LC-MS based steroid profiling would be very helpful in the diagnostic process of patients with CS.