Salivary cortisol and the diagnosis of Cushing’s syndrome: a coming of age

Excerpt

The diagnosis and differential diagnosis of endogenous hypercortisolism—the Cushing’s syndrome—is one of the most challenging problems in clinical endocrinology. Screening the large proportion of the population with one or more of the signs and symptoms of Cushing’s syndrome requires a simple, inexpensive, and reliable test [1]. As has been demonstrated in multiple studies, the measurement of an increased late-night salivary cortisol (LNSC) clearly fits the bill because of its high sensitivity and specificity for the diagnosis of Cushing’s syndrome [2]. The theory behind the test and its execution has been exhaustively reviewed and is now widely accepted [3, 4]. …