METHOD FOR PREDICTION OF GLUCOCORTICOID ADRENAL INSUFFICIENCY IN PATIENTS WITH CUSHING SYNDROME IN EARLY POSTOPERATIVE PERIOD Russian patent published in 2025 - IPC G01N33/74 G01N33/533 G01N30/70 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endocrinology, surgery and clinical laboratory diagnostics, and can be used for the early postoperative prediction of glucocorticoid insufficiency in the patients with Itsenko-Cushing syndrome. It involves immunochemiluminescent assay (ICLA). High-performance liquid chromatography (HPLC) and gas chromatography with mass spectrometric detection (GC-MS) are carried out. When performing ICLA, blood cortisol levels are determined at 21 (Ct) and in a dexamethasone test (Cdmt). When performing HPLC, determining the urinary excretion of free cortisol (UFF), free cortisone (UFE); blood corticosterone (B) and 11-deoxycortisol (S). When performing GC-MS, the urinary excretion rates of tetrahydrocorticosterone (THB) and tetrahydro-11-deoxycortisol (THS) are determined in patients with CS in the preoperative period. If observing following 8 signs in the patients with Itsenko-Cushing syndrome, glucocorticoid insufficiency in the early postoperative period is predicted in the patients with Itsenko-Cushing syndrome: cortisol at 21 (Ct) more than 427 nmol/l; when conducting test with 1 mg of dexamethasone, Cdmt is more than 383 nmol/l; if B is more than 2.0 ng/ml in blood; if S is more than 1.1 ng/ml in blood; with urinary excretion of UFF more than 124 mcg/day; with urinary excretion of UFE more than 88 mcg/day; with urinary excretion of THB more than 210 mcg/day; with urinary excretion of THS more than 249 mcg/day.

EFFECT: method provides an opportunity to increase the sensitivity and specificity of the early postoperative glucocorticoid insufficiency prediction in the patients with Itsenko-Cushing syndrome due to the quantitative determination of blood and urine corticosteroids by HPLC and the analysis by the ICLA and GC-MS.

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