| Bilateral and simultaneous sinus petrosus inferior catheterization in patients with Cushing's syndrome: plasma-immunoreactive-ACTH-concentrations before and after administration of CRF. | |
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MedLine Citation:
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PMID: 2832295 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The ACTH-producing microadenoma is by far the most common cause of hypercortisolism in patients with Cushing's syndrome. Selective transsphenoidal surgery is the treatment of choice for Cushing's disease, however, it is not uniformly successful. Aim of this study was to determine simultaneously the ACTH-concentration in the right and left sinus petrosus inferior in patients with Cushing's syndrome before and after stimulation with CRF. The procedure was attempted in 17, successfully carried out in 16 patients. In the 14 of whom Cushing's disease was diagnosed, 11 had a gradient greater than 1.4 (central versus peripheral ACTH) after administration of CRF, two patients had no gradient, yet responded to CRF. One patient had the ectopic ACTH-syndrome and showed no response to CRF and no gradient. One patient, found to have no Cushing's disease, had no gradient and responded normal to CRF. In 9 of the 11 patients with a gradient, the microadenoma was found on the side of the higher ACTH-level; one patient underwent hemihypophysectomy of the side where the gradient was directed towards and was cured. No complications occurred. We conclude, that selective, simultaneous and bilateral catheterization of the sinus petrosus inferior is a safe method to localize the side of the microadenoma preoperatively. |
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Authors:
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H M Schulte; B Allolio; R W Günther; G Benker; R Windeck; W Winkelmann; D Reinwein |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Hormone and metabolic research. Supplement series Volume: 16 ISSN: 0170-5903 ISO Abbreviation: Horm. Metab. Res. Suppl. Publication Date: 1987 |
Date Detail:
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Created Date: 1988-05-10 Completed Date: 1988-05-10 Revised Date: 2007-07-23 |
Medline Journal Info:
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Nlm Unique ID: 0330417 Medline TA: Horm Metab Res Suppl Country: GERMANY, WEST |
Other Details:
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Languages: eng Pagination: 66-7 Citation Subset: IM |
Affiliation:
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Medizinische Klinik Universität Kiel, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
/
blood,
complications,
surgery Adolescent Adrenocorticotropic Hormone / blood* Adult Catheterization* Child Corticotropin-Releasing Hormone / diagnostic use* Cranial Sinuses* Cushing Syndrome / blood*, etiology, surgery Female Humans Male Middle Aged Pituitary Neoplasms / blood, complications, surgery |
| Chemical | |
Reg. No./Substance:
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9002-60-2/Adrenocorticotropic Hormone; 9015-71-8/Corticotropin-Releasing Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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