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Glucocorticoid excess (Cushing’s syndrome)


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Suspected or confirmed Cushing's syndrome
  • Category 2
    (appointment within 90 calendar days)
    • Low risk of Cushing's syndrome
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Detailed history including: central obesity, hypertension, osteoporosis, muscle weakness, diabetes mellitus, emotional liability
  • ELFTs
  • Glucose
  • 24-hour urine free cortisol and/or, 1mg overnight dexamethasone suppression test

3. Additional referral information Useful for processing the referral

  • If confirmed hypercortisolism and ACTH is suppressed then CT adrenal
  • Mid-night salivary cortisol

4. Request

Last updated: 13 June 2023