Document Detail


Bilateral and simultaneous sinus petrosus inferior catheterization in patients with Cushing's syndrome: plasma-immunoreactive-ACTH-concentrations before and after administration of CRF.
MedLine Citation:
PMID:  2832295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H M Schulte; B Allolio; R W Günther; G Benker; R Windeck; W Winkelmann; D Reinwein
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Hormone and metabolic research. Supplement series     Volume:  16     ISSN:  0170-5903     ISO Abbreviation:  Horm. Metab. Res. Suppl.     Publication Date:  1987  
Date Detail:
Created Date:  1988-05-10     Completed Date:  1988-05-10     Revised Date:  2007-07-23    
Medline Journal Info:
Nlm Unique ID:  0330417     Medline TA:  Horm Metab Res Suppl     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  66-7     Citation Subset:  IM    
Affiliation:
Medizinische Klinik Universität Kiel, Germany.
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MeSH Terms
Descriptor/Qualifier:
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:
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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