Consensus statement by the French Society of Endocrinology (SFE) and French Society of Pediatric Endocrinology & Diabetology (SFEDP) on diagnosis of Cushing's syndrome

Cushing's syndrome is defined by prolonged exposure to glucocorticoids, leading to excess morbidity and mortality. Diagnosis of this rare pathology is difficult due to the low specificity of the clinical signs, the variable severity of the clinical presentation, and the difficulties of interpretation associated with the diagnostic methods. The present consensus paper by 38 experts of the French Society of Endocrinology and the French Society of Pediatric Endocrinology and Diabetology aimed firstly to detail the circumstances suggesting diagnosis and the biologic diagnosis tools and their interpretation for positive diagnosis and for etiologic diagnosis according to ACTH-independent and-dependent mechanisms. Secondly, situations making diagnosis complex (pregnancy, intense hypercortisolism, fluctuating Cushing's syndrome, pediatric forms and genetically determined forms) were detailed. Lastly, methods of surveillance and diagnosis of recurrence were dealt with in the final section. (c) 2022 Elsevier Masson SAS. All rights reserved.

Automated summary

Cushing's syndrome is a rare condition characterized by prolonged exposure to glucocorticoids, which leads to increased morbidity and mortality. Diagnosis of this syndrome is challenging due to the nonspecific clinical signs, variability in clinical presentation severity, and difficulties in interpreting diagnostic methods. A consensus paper by experts in the field aimed to provide detailed information on the diagnostic criteria, biological diagnostic tools, and interpretation for positive diagnosis and etiological diagnosis based on ACTH-independent and dependent mechanisms. Complex situations such as pregnancy, intense hypercortisolism, fluctuating Cushing's syndrome, pediatric forms, and genetically determined forms were also discussed. Additionally, methods for surveillance and diagnosis of recurrence were addressed.