Diagnostic challenges in cyclic Cushing's syndrome: a systematic review
Authors' conclusion
Variations in biochemical test results due to unpredictable cycle duration and frequency might cause diagnostic challenges resulting in misdiagnoses and missed diagnoses.
Study context
- Population
- Published single case reports and case series of cyclic Cushing's syndrome118 articles
- Participants
- 212 participants
- Comparison
- Cyclic vs non-cyclic CS
- Cyclic CSn = 212
- Outcome
- Aetiology of cyclic CS
Methodological detailsMEDLINE from inception to Oct 10, 2022
- MEDLINE from inception to Oct 10, 2022
Pooled result
As reported in the abstract
- Pituitary tumours
- 67% (n=143)
- Ectopic tumours
- 17% (n=36)
- Adrenal tumours
- 11% (n=23)
- Occult tumours
- 2% (n=4)
- Unclassified
- 3% (n=6)
Further pooled results
| Outcome | P value |
|---|---|
| Remission rates and time to remission | P < 0.001 |
- Remission rates and time to remission: remission rates lower and time to remission longer with cyclic CS
Clinical symptoms and comorbidities
- No major difference between cyclic and non-cyclic CS
Bilateral inferior petrosal sinus sampling in adrenocorticotropic hormone (ACTH)-dependent cyclic CS
- PPV and NPV when performed during hypercortisolism
- 100%
- PPV irrespective of cortisolaemic status
- 73%
- NPV irrespective of cortisolaemic status
- 86%
Safety
- Unnecessary surgery due to misclassification — Cyclic CS
- 6%
Original publication
Diagnostic challenges in cyclic Cushing's syndrome: a systematic review. Lancet Diabetes Endocrinol. Published 7 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →