How Do Doctors Diagnose Cushing Syndrome?
The doctor will go over your child’s health history and do a physical exam. They might also do screening tests to figure out if your child’s body is making high levels of cortisol.
Screening tests may include:
- A 24-hour urine collection for cortisol measurements
- Late-night saliva sample (11 p.m. to midnight) for cortisol measurement
- Assessment of a morning (8 a.m.) cortisol level following administration of oral dexamethasone at 11 p.m. the previous night
If 2 out the 3 screening tests show high cortisol levels, the doctor will do more tests to figure out the cause of endogenous cortisol production, such as a pituitary tumor making an excess of ACTH (also called Cushing Disease), an adrenal tumor, or a tumor at a different site making too much of ACTH or a hormone that stimulates ACTH production (Ectopic Cushing Syndrome). These tests include:
- An ACTH level
- Imaging studies, such as an MRI or CT scan (to look at the pituitary gland, adrenal glands or other places for tumors)
- Other tests that depend on the results of the previous tests