Consensus on the diagnosis of Cushing’s disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society

Jeongmin Lee; Hidenori Fukuoka; Seung Shin Park; A Ram Hong; Jung Hee Kim; Sang Ouk Chin; Han-Sang Baek; Dong-Jun Lim; Kazunori Kageyama; Mitsuru Nishiyama; Shigeyuki Tahara; Ken-Ichi Oyama; Akira Sugawara; Miho Yamashita; Naoko Inoshita; Hiroshi Arima; Byung-Joon Kim; Yoon-Sok Chung; Soon Jib Yoo; Michio Otsuki; Mi-kyung Kim; The Committee of Clinical Practice Guideline of Korean Endocrine Society; Korean Neuroendocrine Study Group of Korean Endocrine Society

doi:10.1507/endocrj.EJ25-0492

This article has now been updated. Please use the final version.

Consensus on the diagnosis of Cushing’s disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society

Jeongmin Lee ^†, Hidenori Fukuoka ^†, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Ken-Ichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, Byung-Joon Kim, Yoon-Sok Chung, Soon Jib Yoo, Michio Otsuki , Mi-kyung Kim , The Committee of Clinical Practice Guideline of Korean Endocrine Society, Korean Neuroendocrine Study Group of Korean Endocrine Society

Author information

Jeongmin Lee ^†
https://orcid.org/0000-0001-9074-8087
Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
Hidenori Fukuoka ^†
https://orcid.org/0000-0001-9255-653X
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Hospital, Kobe 650-0017, Japan
Seung Shin Park
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
A Ram Hong
https://orcid.org/0000-0002-2494-9902
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea
Jung Hee Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
Sang Ouk Chin
Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Korea
Han-Sang Baek
Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
Dong-Jun Lim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
Kazunori Kageyama
Division of Diabetes, Metabolism, and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi 981-8551, Japan
Mitsuru Nishiyama
Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi 783-8505, Japan
Shigeyuki Tahara
Department of Neurological Surgery, Nippon Medical School, Musashikosugi Hospital, Kanagawa 211-8233, Japan
Ken-Ichi Oyama
Department of Neurosurgery, International University of Health and Welfare, Mita Hospital, Tokyo 108-8329, Japan
Akira Sugawara
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, Sendai 980-8578, Japan
Miho Yamashita
Department of Endocrinology and Metabolism, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Naoko Inoshita
Department of Pathology, Moriyama Memorial Hospital, Tokyo 134-0081, Japan
Hiroshi Arima
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 464-8601, Japan
Byung-Joon Kim
Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21936, Korea
Yoon-Sok Chung
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon 16499, Korea
Soon Jib Yoo
Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
Michio Otsuki Corresponding author
https://orcid.org/0000-0001-5947-8621
Department of Endocrinology, Tokyo Women’s Medical University School of Medicine, Tokyo 162-8666, Japan
Mi-kyung Kim Corresponding author
https://orcid.org/0000-0003-1111-9122
Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Korea
The Committee of Clinical Practice Guideline of Korean Endocrine Society
Korean Neuroendocrine Study Group of Korean Endocrine Society
Author contributions

†These authors contributed equally: Jeongmin Lee, Hidenori Fukuoka

Keywords: Cushing Syndrome, Pituitary ACTH Hypersecretion, Diagnosis, Consensus

JOURNAL OPEN ACCESS Advance online publication
Supplementary material

Article ID: EJ25-0492

DOI https://doi.org/10.1507/endocrj.EJ25-0492

The final version of this article is now available: Vol. 73 (2026), No. 2 pp. 355-366

Details

Abstract

Cushing’s disease (CD) is a rare but serious endocrine disorder caused by excessive cortisol secretion due to adrenocorticotropic hormone–secreting pituitary tumors. Despite recent developments in diagnostic criteria and treatment options, CD remains associated with substantial comorbidities and mortality. Early and accurate diagnosis is thus essential. Both the Korean Endocrine Society (KES) and Japan Endocrine Society (JES) guidelines are intended to standardize diagnostic approaches to CD, and they share common principles; however, notable differences exist, particularly in biochemical testing thresholds and imaging recommendations. This consensus statement integrates clinical evidence and expert practice from both the KES and JES to establish harmonized recommendations for biochemical evaluation, imaging, and differential testing. This unified framework is intended to enhance diagnostic precision and improve clinical outcomes across East Asian populations.

Corresponding author

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