When is a dexamethasone suppression, 2-day test indicated in the evaluation of androgen excess?

Updated: Mar 14, 2018
  • Author: Mohamed Yahya Abdel-Rahman, MD, MSc; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

This test can be used to determine the source of significantly elevated androgens. After drawing baseline DHEAS, testosterone, and cortisol, the patient is give 8 doses of 0.5 mg of dexamethasone over a period of 48 hours and these tests are redrawn. An adrenal source is suggested if testosterone is suppressed more than 40% and DHEAS is suppressed more than 60%. An ovarian source is suggested if testosterone is not suppressed while DHEAS and cortisol are both suppressed. A combined source is suggested if DHEAS and cortisol are suppressed and testosterone is suppressed less than 40%. If DHEAS is not suppressed, Cushing syndrome or adrenal cancer must be considered.


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