[Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing's syndrome].
نویسندگان
چکیده
OBJECTIVE To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found. SUBJECTS AND METHODS Fourteen patients with suspected Cushing's syndrome underwent bilateral inferior petrosal sinuses (IPS) catheterization between 2009 and 2012. The technique for catheterization and for hormone analysis were described. RESULTS The procedure was well tolerated by all patients, and adequate catheterization was achieved in 92.85% of cases. The diagnosis of Cushing's disease was confirmed in 10 cases. The result of IPS catheterization after CRH infusion was coherent in all cases, without false negatives. CONCLUSION The catheterization of IPS, despite being an invasive technique, is a safe procedure. The objectives can be done properly in most cases. When well indicated, this procedure remains the gold standard in distinguishing the ectopic form to pituitary source in Cushing's syndrome.
منابع مشابه
Adrenocorticotropic hormone-dependent Cushing's syndrome: sensitivity and specificity of inferior petrosal sinus sampling.
BACKGROUND AND PURPOSE Determining the cause of Cushing's syndrome can be difficult. Bilateral inferior petrosal sinus (IPS) sampling after ovine corticotropin-releasing hormone (oCRH) stimulation is an established technique for the differentiation of pituitary from nonpituitary sources of adrenocorticotropic hormone (ACTH) production. The purpose of this study was to review our experience to d...
متن کاملBilateral sequential inferior petrosal sinus sampling with corticotrophin-releasing hormone stimulation in the diagnosis of Cushing's disease.
OBJECTIVE The demonstration of a central to peripheral ACTH gradient in a hypercortisolaemic patient is diagnostic of Cushing's disease. We tried to determine whether single blood samples for ACTH obtained sequentially from each of the inferior petrosal sinuses following human corticotrophin-releasing hormone (hCRH) stimulation can reliably establish such a gradient. DESIGN Prospective study....
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INTRODUCTION Cushing's syndrome results from inappropriate exposure to excessive glucocorticoids. Untreated, it has significant morbidity and mortality. CASE OUTLINE A 38-year-old woman with a typical appearance of Cushing's syndrome was admitted for further evaluation of hypercortisolism. The serum cortisol level was elevated without diurnal rhythm, without adequate suppression of cortisol a...
متن کاملBilateral inferior petrosal sinus sampling in the management of ACTH-dependent Cushing's syndrome.
متن کامل
The role of bilateral inferior petrosal sinus sampling in the diagnosis of Cushing's syndrome.
Adrenocorticotropin hormone (ACTH)-dependent Cushing's syndrome is most often due to a pituitary corticotroph adenoma, with ectopic ACTH-secreting tumors representing approximately 15% of cases. Biochemical and radiological techniques have been established to help distinguish between these two entities, and thus aid in the localization of the neoplastic lesion for surgical resection. The test t...
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عنوان ژورنال:
- Arquivos brasileiros de endocrinologia e metabologia
دوره 58 7 شماره
صفحات -
تاریخ انتشار 2014