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Diagnosis and Complications of Cushing’s Syndrome: A Consensus Statement

Division of Endocrinology (G.A., B.K., T.M., M.B.), Department of Internal Medicine, University of Ancona, 60100 Ancona, Italy; Division of Internal Medicine (A.A.), Department of Clinical and Biological Science, University of Torino, 10063 Torino, Italy; Regional Centre for Endocrinology and Diabetes (A.B.A.), Royal Victoria Hospital and Queen’s University, BT126BA Belfast, United Kingdom; Department of Endocrinology (X.B.), University Renè Descartes and Institut Cochin, Institut National de la Santé et de la Recherche Médicale U567 and Faculty Cochin, 75014 Paris, France; Department of Endocrinology (F.C.), San Luca Hospital, Italian Auxological Institute, Instituto di Ricovero e Cura a Carattere Scientifico, University of Milan, 20149 Milan, Italy; National Institute of Child Health and Human Development, National Institutes of Health (G.P.C., L.K.N.), Bethesda, Maryland 20892-1583; Department of Psychology (G.A.F.), University of Bologna, 40127 Bologna, Italy; Endocrine-Diabetes Center (J.W.F.), St. Luke’s Medical Center, Milwaukee, Wisconsin 53215; Division of Endocrinology, Diabetology, and Metabolism (R.C.G.), University Hospital, Centre Hospitalier Universitaire Vandois, CH-1011 Lausanne, Switzerland; Department of Endocrinology (A.B.G.), St. Bartholomew’s Hospital, London EC1A 7BE, United Kingdom; Department of Medicine (A.L.), Centre hospitalier de l’Université de Montréal, H2W1T7 Montréal, Canada; Division of Endocrinology (F.M.), Department of Medical and Surgical Sciences, University of Padova, 35128 Padova, Italy; Division of Clinical Sciences (J.N.-P.), Sheffield University, Northern General Hospital, 557AU Sheffield, United Kingdom; Department of Statistical Sciences and Department of Mental Health (N.S.), University of Padova, 35128 Padova, Italy; University of Virginia Health System (M.L.V.), Charlottesville, Virginia 22908-0746; and Department of Internal Medicine/Endocrine Section (A.G.), University of Brescia, 25125 Brescia, Italy

Address all correspondence and requests for reprints to: Dr. Giorgio Arnaldi, Clinica di Endocrinologia Azienda Ospedaliera Umberto I, Sede Torrette 60100 Ancona, Italia. E-mail: g.arnaldi{at}aoumbertoprimo.marche.it.

In October 2002, a workshop was held in Ancona, Italy, to reach a Consensus on the management of Cushing’s syndrome. The workshop was organized by the University of Ancona and sponsored by the Pituitary Society, the European Neuroendocrine Association, and the Italian Society of Endocrinology. Invited international participants included almost 50 leading endocrinologists with specific expertise in the management of Cushing’s syndrome. The consensus statement on diagnostic criteria and the diagnosis and treatment of complications of this syndrome reached at the workshop is hereby summarized.

Participants in the Consensus Workshop were: B. Ambrosi, A. Angeli, G. Arnaldi, E. Arvat, A. B. Atkinson, X. Bertagna, M. Boscaro, F. Casanueva, F. Cavagnini, G. P. Chrousos, R. N. Clayton, A. Colao, Y. de Keyzer, W. de Herder, G. Faglia, F. Fallo, G. A. Fava, J. W. Findling, R. C. Gaillard, M. Gasperi, A. Giustina, A. B. Grossman, B. Kola, A. Lacroix, A. Lania, R. Lauro, P. Loli, M. Losa, T. Mancini, M. Mannelli, F. Mantero, J. Newell-Price, L. K. Nieman, R. Pasquali, F. Pecori Giraldi, R. Pivonello, M. Reincke, F. Santeusanio, M. T. Sartori, N. Sonino, G. K. Stalla, M. Terzolo, S. Tsagarakis, M. L. Vance, and R. Vettor.

Abbreviations: BIPSS, Bilateral IPS sampling; BMD, bone mineral density; CBG, corticosteroid-binding globulin; CD, Cushing’s disease; CS, Cushing’s syndrome; CT, computed tomography; DEXA, dual energy x-ray absorptiometry; DST, dexamethasone suppression test(s); IPS, inferior petrosal sinus; MRI, magnetic resonance imaging; UFC, urinary free cortisol.

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