Cushing

Koroğlu Ekin Yiğit; Didem Ozdemir; Muhammed Sacıkara; Husniye Başer; Oya Topaloğlu; Reyhan Ersoy; Bekir Cakir

doi:10.1530/endoabs.99.EP1027

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Endocrine Abstracts (2024) 99 EP1027 | DOI: 10.1530/endoabs.99.EP1027

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Cushing’s vs pseudo-cushing’s: neutrophil-lymphocyte ratio assessment

Ekin Yiğit Köroğlu ¹ , Didem Özdemir ² , Muhammed Saçıkara ¹ , Hüsniye Başer ² , Oya Topaloğlu ² , Reyhan Ersoy ² & Bekir Cakir ²

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¹Ankara Bilkent City Hospital, Endocrinology and Metabolism, Cankaya; ²Ankara Yıldırım Beyazıt University Faculty Of Medicine, Endocrinology and Metabolism, Cankaya

Objective: The neutrophil-lymphocyte ratio may increase in Cushing’s Syndrome. We aimed to demonstrate the usability of the neutrophil-lymphocyte ratio in the differentiation of Cushing’s Syndrome and Pseudo-Cushing’s Syndrome, whose differential diagnosis is clinically and laboratory challenging.

Material and Methods: 23 patients were included in the study. Patients were divided into Cushing’s Syndrome and Pseudo-Cushing’s Syndrome groups according to clinical findings and combined Dexamethasone-CRH test results (with cut-offs of 1.4 mg/dl, 3.1 mg/dl, and 3.9 mg/dl). The neutrophil and lymphocyte values and screening tests of Cushing’s Syndrome were recorded. The neutrophil-lymphocyte ratio was calculated and compared between Cushing’s Syndrome and Pseudo-Cushing’s Syndrome groups.

Results: The neutrophil-lymphocyte ratio differed significantly when we grouped patients clinically (2.47±1.38 vs 1.51±0.44, P=0,033). Since only one patient was evaluated as having Pseudo-Cushing’s Syndrome with a cut-off value of 1.4 mg/dl, statistical analysis could not be performed for this value. When grouping was made according to the 3.1 mg/dl cut-off, there was no significant difference in neutrophil-lymphocyte ratio (2.41±1.50 vs 1.63±0.51, P=0.095). When patients were grouped according to a cut-off of 3.9 mg/dl, the neutrophil-lymphocyte ratio was significantly higher in those with Cushing’s Syndrome (2.68±1.57 vs 1.59±0.49, P=0,021).

Conclusion: The neutrophil-lymphocyte ratio is significantly higher in Cushing’s Syndrome patients than in Pseudo-Cushing’s Syndrome patients. However, instead of using this parameter alone for diagnosis, it would be more accurate to use it as a contributor to other tests.