A diagnosis of pseudo-Cushing's syndrome using dexamethason/CRH and Alprazolam

JRCT ID: jRCT1021210011

Registered date:13/04/2022

Basic Information

• Recruitment status: Recruiting
• Health condition(s) or Problem(s) studied: Pseudo Cushing's Syndrome
• Date of first enrollment: 13/04/2022
• Target sample size: 20
• Study type: Interventional
• Intervention(s): In patients suspected of having Cushing's syndrome or pseudo-Cushing's syndrome, we perform two loading tests, DEX/CRH and alprazolam tests, in order to confirm the differential ability of these tests.

Outcome(s)

Primary Outcome

ACTH, cortisol, salivary cortisol at midnight after administering alprazolam.
Early morning ACTH and cortisol the day after alprazolam oral administration followed by 0.5mg dexamethasone use.
ACTH and cortisol 15 minutes later after administering dexamethasone 0.5 mg every 6 hrs for a total of 8 doses, followed by CRH loading.

• Secondary Outcome: Urinary free cortisol in the early morning after administering alprazolam (spot urine)

Key inclusion & exclusion criteria

• Age minimum: Not applicable
• Age maximum: Not applicable
• Gender: Both
• Include criteria: This study will be conducted in patients with both high basal ACTH and cortisol levels who have a cortisol level of >=3 mcg/dl on a 0.5 mg dexamethasone suppression test or have a midnight cortisol level of >=5 mcg/dl.

Exclude criteria

Those who are long-term user of steroids should be excluded.
In addition, if the blood glucose of patients is consistently above 300 mg/dl, they should be excluded because dexamethasone may exacerbate hyperglycemia.

Related Information

• Primary Sponsor: Asari Yuko