Role of Low Dose Overnight Dexamethasone Supression Test (Lodst) in Management Protocol for Cushing’s Syndrome | Chapter 7 | Highlights on Medicine and Medical Research Vol. 4

Introduction: Overnight low dose The Dexamethasone Supression Test (LODST) is a diagnostic method for Cushing's syndrome that occurs spontaneously (CS). A negative LODST law rules out CS. However, there are two exceptions: monitoring during the silent phase of Cyclic Cushing's disease (CD) or a false negative caused by one mg dexamethasone in early or moderate CD.

Methods: We looked at the age and sex data of 154 LOSDT participants to see if there was a connection between CS and age.

The detection rate of CS by LOSDT is 26%, with a 95 percent confidence interval of Cortisol (211.27 to 373.69 nmol/L). 45 (29.2%) of the 154 cases are children, and 109 (70.8%) of the cases are female. The CS group's sex and age ratios are similar to the rest (sig.>.136), but their age is slightly higher, with a Mean Difference of 2.46 - 13.31 years ( sig. 005).

The binary logistic regression equation revealed that the CS population is substantially different (.000), and that this difference is influenced by their age (sig..021) but not by their gender or age group (sig. >.743). As a result, age is a distinct risk factor for CS.

Conclusion: We agree that LODST should be used as the first method for CS. Newer imaging and biochemical methods can be used to determine LODST negative events. Only imaging-positive incidentoloma should be treated according to the incidentoloma guidelines. If the age is greater than 30 years or the symptoms score suggests that CD and rest are to be ruled out, negative cases with both tools must be enrolled in follow-up protocols. We would be able to formulate a more cost-effective management policy for CS by analysing combined diagnostic and outcome results.

Author (s) Details

Tofail Ahmed
Department of Endocrinology, Bangladesh Institute for Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Diabetic Association of Bangladesh, Bangladesh.

Hajera Mahtab
Department of Endocrinology, Bangladesh Institute for Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Diabetic Association of Bangladesh, Bangladesh.

Tania Tofail
Department of Endocrinology, Bhangabando Sheikh Mujibur Medical University, Bangladesh.

Md. A. H. G. Morshed
Endocrinology Laboratory, BIRDEM, Diabetic Association of Bangladesh, Bangladesh.

Fatema B. Rahman
Endocrinology Laboratory, BIRDEM, Diabetic Association of Bangladesh, Bangladesh.

Shahidul A. Khan
Endocrinology Laboratory, BIRDEM, Diabetic Association of Bangladesh, Bangladesh.

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