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Table 2 Endocrinological data of loading test

From: A case of autonomous cortisol secretion in a patient with subclinical Cushing’s syndrome, GNAS mutation, and paradoxical cortisol response to dexamethasone

Loading agent Variable, unit Value, pre-operation Value, post-operation Reference range
1 mg of DEX, overnight Serum cortisol, μg/dL 11.8 4.6 <  1.8
8 mg of DEX, overnight Serum cortisol, μg/dL 13.1 8.7 <  1.0
100 μg of CRH intravenously Basal ACTH, pg/mL 2.7 2.6 7.2–63.3
  Peak ACTH, pg/mL (time, min) 5.2 (90) 9.1 (90) >  2× basal ACTH
2 L of saline intravenously PAC (before loading), pg/mL 78 73 29.9–159
  PAC (after loading), pg/mL 92 81 <  60
50 mg of captopril orally PAC (0 min), pg/mL 56 114 29.9–159
  PAC (60 min), pg/mL 59 102 N/A
  PAC (90 min), pg/mL 50 82 N/A
  ARR (0 min) 140 285 <  200
  ARR (60 min) 590 102 <  200
  ARR (90 min) 496 74 <  200
40 mg of furosemide intravenously with keeping upright PRA (0 min), ng/mL/h 0.3 0.4 0.3–2.9
PRA (60 min), ng/mL/h 0.3 0.5 >  2.0
PRA (120 min), ng/mL/h 0.4 0.8 >  2.0
<Dexamethasone suppression test, Liddle’s method>
No DEX Urinary- free cortisol, μg/day 74 14 11.2–80.3
2 mg/day of DEX, the first day Urinary- free cortisol, μg/day 538 32  
2 mg/day of DEX, the second day Urinary- free cortisol, μg/day 284 28  
8 mg/day of DEX, the first day Urinary- free cortisol, μg/day 141 21  
8 mg/day of DEX, the second day Urinary- free cortisol, μg/day 136 20  
  1. Overnight suppression test with 1 mg and 8 mg of DEX did not suppress cortisol levels, but paradoxically resulted in an increase in urinary cortisol levels
  2. DEX, dexamethasone; CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropic hormone; PAC, plasma aldosterone concentration; ARR, plasma aldosterone / plasma renin activity ratio; PRA, plasma renin activity; N/A, not applicable