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In a 66-year-old woman with a 2.3 cm pituitary macroadenoma, class II obesity on tirzepatide (Mounjaro), prediabetes, hypertension, ACTH of 14 pg/mL, postlowdose dexamethasone cortisol of 4.5 g/dL, 24hour urine cortisol of 66 g/24 h, and normal prolactin, IGF1, LH, FSH, free T4 and TSH, what is the cause of the abnormal lowdose dexamethasone suppression test?
Ortega R et al
