Medium-dose dexamethasone suppression test

The mid-dose dexamethasone suppression test was performed by the following principles: masculine innate adrenal hyperplasia, such as 21 hydroxylase deficiency patients due to cortisol synthesis disorders, ACTH feedback secretion increased, leading to adrenal hyperplasia and adrenal gland Increased ketone (urine 17-KS, 17-KGS increased). When the appropriate amount of exogenous synthetic corticosteroid dexamethasone was administered to inhibit the excessive release of ACTH, the levels of urinary 17-KS and 17-KGS decreased. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value 1. After taking the drug, 17-KS is more positive than the control value >50% (can be inhibited), supporting the diagnosis of congenital adrenal hyperplasia. 2. The increase in 17-KS caused by adrenal adenoma or gonadal disease is not inhibited. Clinical significance Abnormal results: congenital adrenal hyperplasia has semi-yin and yang external genitalia, melanin deposition, dehydration, plus hypokalemia, hyperkalemia and metabolic acidosis, elevated serum 17-OHP, urine pregnanetriol (17-OHP urine) Elevated fluid metabolites, elevated plasma renin activity and other symptoms. Adrenal adenoma or gonadal disease 1. Adrenal adenoma Adenoma is usually unilaterally single, with a thin layer of envelope, oppressive surrounding tissue, the main point of identification. The size is 1~5cm in diameter, the cut surface is yellow, sometimes reddish brown, and the mirror is mostly foamy transparent cells like bundles. It is rich in lipidoids, sometimes composed of eosinophils with less lipid content, or two kinds. The cells are mixed. Tumor cells are arranged in clusters and are separated by a small amount of interstitial cells containing capillaries. Some adenomas are functional and can cause hyperaldosteronism or Cushing syndrome. People to be examined: Patients with congenital adrenal hyperplasia can also be used in patients who need to distinguish between congenital adrenal hyperplasia and adrenal adenoma or gonadal disease. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. Inspection process [method] 1. On the first day, 24h urine test 17-KS (and / or 17-KGS) was taken as a control. 2. On the second day, oral dexamethasone 0.75mg, q6h, for 5 consecutive days. 3. Collect 24h urine test 17-KS (and/or 17-KGS) on the 3rd and 5th day after taking the drug. [Result analysis] If the patient's 24-h urine 17-KS (and / or 17-KGS) control is slightly higher than normal, dexamethasone is inhibited to less than 50% after inhibition, except for congenital adrenal hyperplasia. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks No related complications or hazards.

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