Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Abstract

Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism. © 2013 European Society of Endocrinology.