October 19, 1999Annals of Internal Medicine
Paradoxical Response to Dexamethasone in the Diagnosis of Primary Pigmented Nodular Adrenocortical Disease
Why the study?
Does the Liddle test distinguish primary pigmented nodular adrenocortical disease from other primary adrenocortical lesions?
Population
45 patients in total: 21 patients with primary pigmented nodular adrenocortical disease, 9 patients with…
Comparison
6-day Liddle test with determination of urinary… vs Patients with macronodular adrenocortical…
Design
Cohort
Follow-up
6 days
Authors
Discussion
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Member takes
Implication
May support Liddle test for distinguishing PPNAD; hypothesis-generating and requires prospective validation.
Structured PICO
Does the Liddle test distinguish primary pigmented nodular adrenocortical disease from other primary adrenocortical lesions?
P
Population
45 patients in total: 21 patients with primary pigmented nodular adrenocortical disease, 9 patients with macronodular adrenocortical disease, and 15 patients with primary unilateral adrenocortical disease (single adenomas).
I
Intervention
6-day Liddle test (dexamethasone administration) with determination of urinary free cortisol and 17-hydroxycorticosteroid excretion
C
Comparator
Patients with macronodular adrenocortical disease and primary unilateral adrenocortical disease (single adenomas)
O
Outcome
Increase in urinary free cortisol levels on day 6 of the Liddle testsurrogate
A paradoxical increase in glucocorticoid excretion during the Liddle test distinguishes primary pigmented nodular adrenocortical disease from other primary adrenal disorders.
Cite This Study
Stratakis et al. (1999) studied this question.