Inferior petrosal sinus sampling and stimulation with CRH: 15 years of experience in a tertiary hospital.
Endocrinol Diabetes Nutr (Engl Ed)
; 68(6): 381-388, 2021.
Article
em En
| MEDLINE
| ID: mdl-34742471
ABSTRACT
BACKGROUND:
Inferior petrosal sinus sampling (IPSS) is indicated in the diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS), especially when the results of the initial diagnostic tests are discordant.OBJECTIVE:
To describe the patients who underwent this invasive functional test in a tertiary hospital.METHODS:
This was an observational study of a retrospective cohort of patients with ACTH-dependent CS and IPSS between 2004 and 2019. We determined their epidemiological, hormonal, radiological and functional characteristics, and evaluated their diagnostic capacity and optimal cut-off points to differentiate between Cushing's disease (CD) and ectopic Cushing's syndrome (ECS).RESULTS:
23 patients were evaluated, of which 65.2% were women with the average age of 42 (36-62) years. ACTH secretion of pituitary origin was evident in 82.6% of the patients and of ectopic origin in 17.4%. Plasma cortisol, urinary free cortisol, and ACTH levels were higher in patients with ECS. Regarding IPSS, the baseline central/peripheral ACTH gradient detected 89.5% of patients with CD and after stimulation with CRH, 100%. The optimal cut-off points in the diagnosis of CD were 2.06 at baseline and 2.49 after CRH stimulation.CONCLUSION:
IPSS with CRH stimulation is a test with a high diagnostic accuracy for correctly classifying patients with CD and ECS. The cut-off points of the gradients may be different from the classic ones. Therefore, we recommend that each center perform its own evaluation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hormônio Liberador da Corticotropina
/
Amostragem do Seio Petroso
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Síndrome de Cushing
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endocrinol Diabetes Nutr (Engl Ed)
Ano de publicação:
2021
Tipo de documento:
Article