Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome

Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome

The dexamethasone suppression test is a useful endocrinological test to diagnose Cushing's syndrome. However, its interpretation may be influenced by many factors such as stress, alcohol, failure to ingest the dexamethasone, altered metabolism, drug interaction and obesity. This report illustra...

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Main Authors: Ngow, Harris Abdullah, Nowalid, Wan Khairina Won Mohd
Format: Article
Language:English
Published: The Polish Society of Endocrinology 2010
Subjects:
RB Pathology
RC Internal medicine
Online Access:http://irep.iium.edu.my/5138/
http://irep.iium.edu.my/5138/
http://irep.iium.edu.my/5138/1/13_Ngow.pdf
id iium-5138
recordtype eprints
spelling iium-51382012-02-10T08:13:45Z http://irep.iium.edu.my/5138/ Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome Ngow, Harris Abdullah Nowalid, Wan Khairina Won Mohd RB Pathology RC Internal medicine The dexamethasone suppression test is a useful endocrinological test to diagnose Cushing's syndrome. However, its interpretation may be influenced by many factors such as stress, alcohol, failure to ingest the dexamethasone, altered metabolism, drug interaction and obesity. This report illustrates such an instance, whereby the result of the test was erratic due to the anti-tuberculous drug rifampicin. Rifampicin has been found to profoundly attenuate the biological effects of dexamethasone, probably by enhancing its metabolism in the liver. The exact mechanism of the drug interaction remains elusive, though induction of hepatic CYP3A4 enzyme complex is a possible mechanism. In a patient treated with rifampicin, the results of dexamethasone suppression tests thus have no diagnostic value and can be very misleading. The Polish Society of Endocrinology 2010 Article PeerReviewed application/pdf en http://irep.iium.edu.my/5138/1/13_Ngow.pdf Ngow, Harris Abdullah and Nowalid, Wan Khairina Won Mohd (2010) Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome. Endokrynologia Polska/ Polish Journal of Endocrinology, 61 (6). pp. 706-9. ISSN 0423-104X http://www.endokrynologia.polska.viamedica.pl/
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic RB Pathology
RC Internal medicine
spellingShingle RB Pathology
RC Internal medicine
Ngow, Harris Abdullah
Nowalid, Wan Khairina Won Mohd
Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
description The dexamethasone suppression test is a useful endocrinological test to diagnose Cushing's syndrome. However, its interpretation may be influenced by many factors such as stress, alcohol, failure to ingest the dexamethasone, altered metabolism, drug interaction and obesity. This report illustrates such an instance, whereby the result of the test was erratic due to the anti-tuberculous drug rifampicin. Rifampicin has been found to profoundly attenuate the biological effects of dexamethasone, probably by enhancing its metabolism in the liver. The exact mechanism of the drug interaction remains elusive, though induction of hepatic CYP3A4 enzyme complex is a possible mechanism. In a patient treated with rifampicin, the results of dexamethasone suppression tests thus have no diagnostic value and can be very misleading.
format Article
author Ngow, Harris Abdullah
Nowalid, Wan Khairina Won Mohd
author_facet Ngow, Harris Abdullah
Nowalid, Wan Khairina Won Mohd
author_sort Ngow, Harris Abdullah
title Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
title_short Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
title_full Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
title_fullStr Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
title_full_unstemmed Abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected Cushing's syndrome
title_sort abnormal dexamethasone suppression tests in a rifampicin-treated patient with suspected cushing's syndrome
publisher The Polish Society of Endocrinology
publishDate 2010
url http://irep.iium.edu.my/5138/
http://irep.iium.edu.my/5138/
http://irep.iium.edu.my/5138/1/13_Ngow.pdf
first_indexed 2023-09-18T20:13:36Z
last_indexed 2023-09-18T20:13:36Z
_version_ 1777407640993792000

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