{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:03Z","timestamp":1787021223984,"version":"build-2736575974"},"reference-count":84,"publisher":"The Endocrine Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Context: The diagnosis, differential diagnosis, and treatment of Cushing\u2019s syndrome are challenging problems in clinical endocrinology. We focus on critical questions addressing screening for Cushing\u2019s syndrome, differentiation of Cushing\u2019s subtypes, and treatment options.<\/jats:p>\n                  <jats:p>Evidence Acquisition: Ovid\u2019s MEDLINE (1996 through April 2006) was used to search the general literature. We also relied on previously published reviews and a recent monograph and cite a mix of primary articles and recent reviews.<\/jats:p>\n                  <jats:p>Evidence Synthesis: Although this article represents our opinion, it draws heavily on a recent consensus statement from experts in the field and a recent monograph on Cushing\u2019s syndrome.<\/jats:p>\n                  <jats:p>Conclusions: We concluded that: 1) measurement of late-night or bedtime salivary cortisol is a useful approach to screen for Cushing\u2019s syndrome; 2) measurement of suppressed plasma ACTH by immunometric assay is useful to differentiate ACTH-dependent and -independent Cushing\u2019s syndrome; 3) inferior petrosal sinus sampling for ACTH should be performed in patients with ACTH-dependent hypercortisolism in whom a pituitary magnetic resonance imaging is normal or equivocal (in the absence of a pituitary ACTH gradient, prolactin levels should be measured to confirm the integrity of venous sampling); 4) computed tomography of the chest and abdomen and somatostatin receptor scintigraphy should be performed in patients with the occult ectopic ACTH syndrome; and 5) patients with Cushing\u2019s disease should be referred to a neurosurgeon with extensive experience operating on corticotroph microadenomas. Bilateral laparoscopic adrenalectomy should be considered in patients with Cushing\u2019s disease who fail therapies directed at the pituitary.<\/jats:p>","DOI":"10.1210\/jc.2006-0997","type":"journal-article","created":{"date-parts":[[2006,7,25]],"date-time":"2006-07-25T22:09:15Z","timestamp":1153865355000},"page":"3746-3753","source":"Crossref","is-referenced-by-count":234,"title":["Cushing\u2019s Syndrome: Important Issues in Diagnosis and Management"],"prefix":"10.1210","volume":"91","author":[{"given":"James W.","family":"Findling","sequence":"first","affiliation":[{"name":"Endocrine-Diabetes Center (J.W.F.) 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