dexamethasone suppression test

デキサメタゾン抑制試験 DST

WordNet

1. undergo a test; "She doesnt test well"
2. any standardized procedure for measuring sensitivity or memory or intelligence or aptitude or personality etc; "the test was standardized on a large sample of students" (同)mental test, mental testing, psychometric test
3. the act of undergoing testing; "he survived the great test of battle"; "candidates must compete in a trial of skill" (同)trial
4. the act of testing something; "in the experimental trials the amount of carbon was measured separately"; "he called each flip of the coin a new trial" (同)trial, run
5. a hard outer covering as of some amoebas and sea urchins
6. put to the test, as for its quality, or give experimental use to; "This approach has been tried with good results"; "Test this recipe" (同)prove, try, try out, examine, essay
7. achieve a certain score or rating on a test; "She tested high on the LSAT and was admitted to all the good law schools"
8. determine the presence or properties of (a substance)
9. show a certain characteristic when tested; "He tested positive for HIV"
10. the failure to develop some part or organ
11. forceful prevention; putting down by power or authority; "the suppression of heresy"; "the quelling of the rebellion"; "the stifling of all dissent" (同)crushing, quelling, stifling
12. the act of withholding or withdrawing some book or writing from publication or circulation; "a suppression of the newspaper" (同)curtailment
13. an examination of the characteristics of something; "there are laboratories for commercial testing"; "it involved testing thousands of children for smallpox"
14. the act of subjecting to experimental test in order to determine how well something works; "they agreed to end the testing of atomic weapons"
15. a corticosteroid drug (trade names Decadron or Dexamethasone Intensol or Dexone or Hexadrol or Oradexon) used to treat allergies or inflammation (同)Decadron, Dexamethasone Intensol, Dexone, Hexadrol, Oradexon
16. tested and proved useful or correct; "a tested method" (同)tried, well-tried
17. tested and proved to be reliable (同)time-tested, tried, tried and true

PrepTutorEJDIC

1. daylight-saving time
2. (人の能力などの)『試験』,考査,テスト / (物事の)『試験』,検済,試錬,実験《+of+名》 / 化学分析;試薬 / =test match / …‘を'『試験する』,検査する / …‘を'化学分析する / (…の)試験を受ける,試験をする《+for+名》
3. (反乱などの)鎮圧;(感情・欲望などの)抑制;(活動の)制限;(発表の)禁止《+of+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/14 01:56:26」(JST)

wiki en

[Wiki en表示]

Dexamethasone suppression test
Diagnostics
Dexamethasone
OPS-301 code	1-797

proopiomelanocortin derivatives
POMC
γ-MSH	ACTH		β-lipotropin
	α-MSH	CLIP	γ-lipotropin		β-endorphin
				β-MSH

The dexamethasone suppression test is designed to diagnose and differentiate among the various types of Cushing's syndrome and other hypercortisol states.

It has also been used in the research of depression.

Physiology

Dexamethasone is an exogenous steroid that provides negative feedback to the pituitary to suppress the secretion of ACTH and CRH. Specifically, dexamethasone binds to glucocorticoid receptors in the pituitary gland, which lies outside the blood brain barrier, resulting in regulatory modulation.

Interpretation

Low-dose and high-dose variations of the test exist.

The test is given at low (usually 1–2 mg) and high (8 mg) doses of dexamethasone and the levels of cortisol are measured to obtain the results.

A low dose dexamethasone suppresses cortisol in individuals with no pathology in endogenous cortisol production. A high dose dexamethasone exerts negative feedback on pituitary ACTH producing cells but not on ectopic ACTH producing cells or adrenal adenoma.

Low-dose

A normal result is decrease in cortisol levels upon administration of low-dose dexamethasone. Results indicative of Cushing's disease involve no change in cortisol on low-dose dexamethasone, but inhibition of cortisol on high-dose dexamethasone. If the cortisol levels are unchanged by low- and high-dose dexamethasone then other causes of Cushing's syndrome must be considered with further work-up necessary.

High-dose

After the high-dose dexamethasone, it may be possible to make further interpretations.

ACTH†	Cortisol	Interpretation
undetectable or low	is not suppressed by high or low doses.	Primary Adrenal Cushing syndrome is likely.
normal to elevated	is not suppressed by high or low doses	Ectopic ACTH syndrome is likely. If an adrenal tumor is not apparent, a chest CT and abdominal CT is indicated to rule out a different tumor secreting ACTH.
elevated	is not suppressed by low doses, but is suppressed by high doses	Cushing's disease should be considered. A pituitary MRI would be needed to confirm.

†ACTH as measured prior to dosing of dexamethasone

Equivocal results should be followed by a CRH stimulation test, with Inferior petrosal sinus sampling.

References

UpToDate Contents

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• 1. デキサメタゾン抑制試験 dexamethasone suppression tests
• 2. 思春期における多嚢胞性卵巣症候群の診断的評価 diagnostic evaluation of polycystic ovary syndrome in adolescents
• 3. クッシング症候群の診断 establishing the diagnosis of cushings syndrome
• 4. クッシング症候群の原因の特定 establishing the cause of cushings syndrome
• 5. 成人における単極性うつ病：疫学、病因、および神経生物学 unipolar depression in adults epidemiology pathogenesis and neurobiology

English Journal

• Combined dexamethasone suppression-corticotrophin-releasing hormone stimulation test in medication-free major depression and healthy volunteers.

• Sher L, Oquendo MA, Burke AK, Cooper TB, John Mann J.SourceNew York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA; James J. Peters Veterans' Administration Medical Center and Icahn School of Medicine at Mount Sinai, 130 West Kingsbridge Road, Bronx, New York, NY, USA. Electronic address: Leo.Sher@mssm.edu.
• Journal of affective disorders.J Affect Disord.2013 Dec;151(3):1108-12. doi: 10.1016/j.jad.2013.06.049. Epub 2013 Jul 15.
• BACKGROUND: The hypothalamic-pituitary-adrenal (HPA) axis is dysfunctional in a subgroup of mood disorders.METHODS: We compared cortisol and adrenocorticotropic hormone (ACTH) responses in major depression and healthy volunteers to the combined dexamethasone suppression-corticotrophin-releasing horm
• PMID 23866302

• No differences between drug naive and drug experienced unipolar depressed patients in terms of neurobiological testing: A cross sectional study.

• Fountoulakis KN, Gonda X, Andreoulakis E, Fokas K, Iacovides A.Source3rd Department of Psychiatry, Medical School, Aristotle University of Thessaloniki, 1st Parodos Ampelonon Street, 55535 Pylaia, Thessaloniki, Greece. Electronic address: kfount@med.auth.gr.
• Journal of psychiatric research.J Psychiatr Res.2013 Dec;47(12):1984-90. doi: 10.1016/j.jpsychires.2013.09.004. Epub 2013 Sep 18.
• Successful antidepressant treatment has been associated with concomitant changes in brain function, consolidated as long as treatment is continued and remission is preserved. The present study aimed at assessing the impact of prior antidepressant treatment on brain function in currently depressed bu
• PMID 24074518

• Effect of dexamethasone or synthetic ACTH administration on endogenous ACTH concentrations in healthy dogs.

• Bugbee AC, Smith JR, Ward CR.SourceDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
• American journal of veterinary research.Am J Vet Res.2013 Nov;74(11):1415-20. doi: 10.2460/ajvr.74.11.1415.
• Objective-To determine the effects of dexamethasone or synthetic ACTH administration on endogenous ACTH concentrations in healthy dogs. Animals-10 healthy neutered dogs. Procedures-Each dog received dexamethasone (0.01 mg/kg), synthetic ACTH (5 μg/kg), or saline (0.9% NaCl) solution (0.5 mL) IV at
• PMID 24168307

Japanese Journal

• サブクリニカルクッシング症候群の概念と臨床的意義

• 成瀬 光栄,田辺 晶代,立木 美香
• 臨床病理 58(3), 232-237, 2010-03-25
• NAID 10026444586

• The Frequency of Type 2 Diabetic Patients who Meet the Endocrinological Screening Criteria of Subclinical Cushing's Disease

• MURAKAMI HIROSHI,NIGAWARA TAKESHI,SAKIHARA SATORU,KAGEYAMA KAZUNORI,YAMASHITA MAKI,MATSUKI KOTA,TANABE JUTARO,MATSUI JUN,TAMASAWA NAOKI,SUDA TOSHIHIRO
• Endocrine journal 57(3), 267-272, 2010-03-01
• NAID 10029584113

Related Links

• anddexamethasonei.wiki.zoho.com

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• Dexamethasone suppression test: MedlinePlus Medical ...

How the Test is Performed During this test, you will receive dexamethasone, and the health care provider will measure your cortisol levels. There are two different types of dexamethasone suppression tests: the low-dose ...

Related Pictures

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★リンクテーブル★

リンク元	「デキサメタゾン抑制試験」「DST」
拡張検索	「low-dose dexamethasone suppression test」
関連記事	「testing」「test」

「デキサメタゾン抑制試験」

　　[★]

英

dexamethasone suppression test, DST

同

(国試)デキサメサゾン抑制試験

関

デキサメタゾン、クッシング症候群、1mgデキサメタゾン抑制試験、8mgデキサメタゾン抑制試験、低用量デキサメタゾン抑制試験、コルチゾール

[show details]

デキサメタゾン抑制試験 : 約 19,000 件
デキサメサゾン抑制試験 : 約 3,830 件

デキサメタゾン抑制テスト : 24 件
デキサメタゾン抑制試験 : 約 22,000 件

概念

• デキサメタゾンはネガティブフィードバックによりACTH分泌を抑制することを利用し、クッシング症候群の診断やスクリーニングに用いられる。

LAB.713改変

ACTH依存性	疾患		デキサメタゾン抑制試験
			少量	8mg
依存	クッシング病 (下垂体型)		抑制無し	抑制
依存	異所性ACTH産生腫瘍		抑制無し	抑制無し
非依存	副腎腫瘍	副腎腺腫	抑制無し	抑制無し
		副腎癌
非依存	原発性副腎過形成		抑制無し	抑制無し

方法

LAB.713

1. 標準法(Liddle原法)

• デキサメサゾン0.5mgを6時間ごとに1日4回(1日量2mg)を2日間連続して経口投与する。負荷前後の尿中17-OHCSまたは尿中遊離コルチゾールを測定する。2mgで抑制されないときには8mg/日の大量を投与する

2. over night test

• 試験前日の11時にデキサメサゾン1-2mg(低用量)を服用させ、翌朝6-8時に空腹臥床で採血し、血漿コルチゾールとACTHを測定する。血漿コルチゾールの抑制がみられない場合には8mg(高用量)を投与する。

基準範囲

1. 標準法(Liddle原法)

• 健常者では、尿中17-OHCSの減少(3mg/日以下)または尿中遊離コルチゾールの減少(25μg/日)がみられる

2. over night test

• 健常者では、血漿コルチゾール5μg/dl以下、ACTHは10pg/ml以下

「DST」

　　[★]

• ドナー特異的輸血 donor-specific blood transfusion
• デキサメタゾン抑制試験 dexamethasone suppression test

　

「low-dose dexamethasone suppression test」

　　[★] 低用量デキサメタゾン抑制試験

「testing」

　　[★]

• n.

• 試験

関

assessment、data quality、exam、examination、examine、experimental design、matched group、measurement、research design、scoring method、test、trial

　 　

「test」

　　[★] テスト