| . | Case 1 . | Case 2 . | Case 3 . | Case 4 . |
|---|---|---|---|---|
| Age at diagnosis, y | 71 | 54 | 71 | 27 |
| Sex | F | F | M | F |
| BMI, kg/m2 (normal <30 kg/m2) | 19.5 | 43 | 33.2 | 34.3 |
| Fasting plasma glucose, mg/dL (normal 65–99 mg/dL) | 253 | 139 | 116 | 115 |
| HbA1c, % (<5.7%) | 7.9 | 8.5 | 6.1 | 6.3 |
| Blood pressure, mm Hg (normal 120/80 mm Hg) | 129/70 | 141/88 | 170/90 | 156/104 |
| Symptoms | Bruising | Cushingoid features | Headaches | Cushingoid features |
| Hematuria | Extreme weakness | Anxiety | Headaches | |
| Insomnia | Anxiety | |||
| Weight gain | Insomnia | |||
| Depression | ||||
| Poor memory and concentration | ||||
| Dizziness | ||||
| Precipitous weight gain | ||||
| Cortisol after 1-mg DST, μg/dL (normal <1.8 μg/dL) | 18 | 18.8 | 2.6 | — |
| LNSC, ng/mLa | 5.075 | 0.6 | 0.62 | |
| 2.43 | 3.9 | 1.23 | 4.06 | |
| (ULN <1.56 ng/mL) | 2.0(ULN <1.5 ng/mL) | (ULN <1.56 ng/mL) | 4.284.935.45.58 | |
| 5.62 | ||||
| 10.26 | ||||
| (ULN <1.49 ng/mL) | ||||
| UFC, μg/d (normal 4–50 μg/d) | 116 | 18.2 | 34.5 | 444.2 |
| 32 | 21.3 | 292.3 | ||
| 69 | 231.7 | |||
| 74 | ||||
| 57 | ||||
| 77 | ||||
| ACTH, pg/mL (normal 6–50 pg/mL) | 13 | Undetectable | Undetectable | Undetectable |
| Undetectableb | ||||
| 8.1b | ||||
| 14.6b | ||||
| DHEA-S, μg/dL | 82 (reference range 7–177 μg/dL) | 36 (reference range 8–188 μg/dL) | — | — |
| Size of nodules, cm | 1.7 (left), enlargement (right) | Diffuse enlargements | 1.9–3.5 | 1.5–2.9 |
| . | Case 1 . | Case 2 . | Case 3 . | Case 4 . |
|---|---|---|---|---|
| Age at diagnosis, y | 71 | 54 | 71 | 27 |
| Sex | F | F | M | F |
| BMI, kg/m2 (normal <30 kg/m2) | 19.5 | 43 | 33.2 | 34.3 |
| Fasting plasma glucose, mg/dL (normal 65–99 mg/dL) | 253 | 139 | 116 | 115 |
| HbA1c, % (<5.7%) | 7.9 | 8.5 | 6.1 | 6.3 |
| Blood pressure, mm Hg (normal 120/80 mm Hg) | 129/70 | 141/88 | 170/90 | 156/104 |
| Symptoms | Bruising | Cushingoid features | Headaches | Cushingoid features |
| Hematuria | Extreme weakness | Anxiety | Headaches | |
| Insomnia | Anxiety | |||
| Weight gain | Insomnia | |||
| Depression | ||||
| Poor memory and concentration | ||||
| Dizziness | ||||
| Precipitous weight gain | ||||
| Cortisol after 1-mg DST, μg/dL (normal <1.8 μg/dL) | 18 | 18.8 | 2.6 | — |
| LNSC, ng/mLa | 5.075 | 0.6 | 0.62 | |
| 2.43 | 3.9 | 1.23 | 4.06 | |
| (ULN <1.56 ng/mL) | 2.0(ULN <1.5 ng/mL) | (ULN <1.56 ng/mL) | 4.284.935.45.58 | |
| 5.62 | ||||
| 10.26 | ||||
| (ULN <1.49 ng/mL) | ||||
| UFC, μg/d (normal 4–50 μg/d) | 116 | 18.2 | 34.5 | 444.2 |
| 32 | 21.3 | 292.3 | ||
| 69 | 231.7 | |||
| 74 | ||||
| 57 | ||||
| 77 | ||||
| ACTH, pg/mL (normal 6–50 pg/mL) | 13 | Undetectable | Undetectable | Undetectable |
| Undetectableb | ||||
| 8.1b | ||||
| 14.6b | ||||
| DHEA-S, μg/dL | 82 (reference range 7–177 μg/dL) | 36 (reference range 8–188 μg/dL) | — | — |
| Size of nodules, cm | 1.7 (left), enlargement (right) | Diffuse enlargements | 1.9–3.5 | 1.5–2.9 |
To convert cortisol and LNSC to nmol/L, multiply by 27.6.
To convert UFC to nmol/d, multiply by 2.76.
To convert ACTH to pmol/L, multiply by 0.22.
To convert DHEA-S to µmol/L, multiply by 0.0271.
LNSC values are from different laboratories with different assays and reference ranges.
Values from tertiary center.
| . | Case 1 . | Case 2 . | Case 3 . | Case 4 . |
|---|---|---|---|---|
| Age at diagnosis, y | 71 | 54 | 71 | 27 |
| Sex | F | F | M | F |
| BMI, kg/m2 (normal <30 kg/m2) | 19.5 | 43 | 33.2 | 34.3 |
| Fasting plasma glucose, mg/dL (normal 65–99 mg/dL) | 253 | 139 | 116 | 115 |
| HbA1c, % (<5.7%) | 7.9 | 8.5 | 6.1 | 6.3 |
| Blood pressure, mm Hg (normal 120/80 mm Hg) | 129/70 | 141/88 | 170/90 | 156/104 |
| Symptoms | Bruising | Cushingoid features | Headaches | Cushingoid features |
| Hematuria | Extreme weakness | Anxiety | Headaches | |
| Insomnia | Anxiety | |||
| Weight gain | Insomnia | |||
| Depression | ||||
| Poor memory and concentration | ||||
| Dizziness | ||||
| Precipitous weight gain | ||||
| Cortisol after 1-mg DST, μg/dL (normal <1.8 μg/dL) | 18 | 18.8 | 2.6 | — |
| LNSC, ng/mLa | 5.075 | 0.6 | 0.62 | |
| 2.43 | 3.9 | 1.23 | 4.06 | |
| (ULN <1.56 ng/mL) | 2.0(ULN <1.5 ng/mL) | (ULN <1.56 ng/mL) | 4.284.935.45.58 | |
| 5.62 | ||||
| 10.26 | ||||
| (ULN <1.49 ng/mL) | ||||
| UFC, μg/d (normal 4–50 μg/d) | 116 | 18.2 | 34.5 | 444.2 |
| 32 | 21.3 | 292.3 | ||
| 69 | 231.7 | |||
| 74 | ||||
| 57 | ||||
| 77 | ||||
| ACTH, pg/mL (normal 6–50 pg/mL) | 13 | Undetectable | Undetectable | Undetectable |
| Undetectableb | ||||
| 8.1b | ||||
| 14.6b | ||||
| DHEA-S, μg/dL | 82 (reference range 7–177 μg/dL) | 36 (reference range 8–188 μg/dL) | — | — |
| Size of nodules, cm | 1.7 (left), enlargement (right) | Diffuse enlargements | 1.9–3.5 | 1.5–2.9 |
| . | Case 1 . | Case 2 . | Case 3 . | Case 4 . |
|---|---|---|---|---|
| Age at diagnosis, y | 71 | 54 | 71 | 27 |
| Sex | F | F | M | F |
| BMI, kg/m2 (normal <30 kg/m2) | 19.5 | 43 | 33.2 | 34.3 |
| Fasting plasma glucose, mg/dL (normal 65–99 mg/dL) | 253 | 139 | 116 | 115 |
| HbA1c, % (<5.7%) | 7.9 | 8.5 | 6.1 | 6.3 |
| Blood pressure, mm Hg (normal 120/80 mm Hg) | 129/70 | 141/88 | 170/90 | 156/104 |
| Symptoms | Bruising | Cushingoid features | Headaches | Cushingoid features |
| Hematuria | Extreme weakness | Anxiety | Headaches | |
| Insomnia | Anxiety | |||
| Weight gain | Insomnia | |||
| Depression | ||||
| Poor memory and concentration | ||||
| Dizziness | ||||
| Precipitous weight gain | ||||
| Cortisol after 1-mg DST, μg/dL (normal <1.8 μg/dL) | 18 | 18.8 | 2.6 | — |
| LNSC, ng/mLa | 5.075 | 0.6 | 0.62 | |
| 2.43 | 3.9 | 1.23 | 4.06 | |
| (ULN <1.56 ng/mL) | 2.0(ULN <1.5 ng/mL) | (ULN <1.56 ng/mL) | 4.284.935.45.58 | |
| 5.62 | ||||
| 10.26 | ||||
| (ULN <1.49 ng/mL) | ||||
| UFC, μg/d (normal 4–50 μg/d) | 116 | 18.2 | 34.5 | 444.2 |
| 32 | 21.3 | 292.3 | ||
| 69 | 231.7 | |||
| 74 | ||||
| 57 | ||||
| 77 | ||||
| ACTH, pg/mL (normal 6–50 pg/mL) | 13 | Undetectable | Undetectable | Undetectable |
| Undetectableb | ||||
| 8.1b | ||||
| 14.6b | ||||
| DHEA-S, μg/dL | 82 (reference range 7–177 μg/dL) | 36 (reference range 8–188 μg/dL) | — | — |
| Size of nodules, cm | 1.7 (left), enlargement (right) | Diffuse enlargements | 1.9–3.5 | 1.5–2.9 |
To convert cortisol and LNSC to nmol/L, multiply by 27.6.
To convert UFC to nmol/d, multiply by 2.76.
To convert ACTH to pmol/L, multiply by 0.22.
To convert DHEA-S to µmol/L, multiply by 0.0271.
LNSC values are from different laboratories with different assays and reference ranges.
Values from tertiary center.
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