Loading...
Please wait, while we are loading the content...
Similar Documents
Bilateral inferior petrosal sinus sampling in the diagnosis of ACTH-dependent Cushing's syndrome: experience in a tertiary hospital.
| Content Provider | Europe PMC |
|---|---|
| Author | Moreno Parro, Isabel Ortiz Sánchez, David García Moreno, Rosa Gómez Rioja, Rubén Frutos Martínez, Remedios Álvarez-Escolá, Cristina |
| Copyright Year | 2022 |
| Abstract | Abstract Objectives Bilateral inferior petrosal sinus sampling (BIPSS) is a useful test for differential diagnosis of central vs. ectopic adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (CS). We provide a description of the protocol used in our Center and an analysis of its diagnostic accuracy. Methods A retrospective study was conducted of 28 patients who underwent BIPSS combined with corticotropin-releasing hormone (CRH) stimulation. The procedure is performed in an interventional neuroradiology suite, involving a multidisciplinary team of neuroradiologists, endocrinologists and laboratory professionals. The two petrosal sinuses are catheterized and a peripheral blood sample is obtained simultaneously, at baseline and at 3, 6 and 10 min following stimulation. ACTH and prolactin are determined by immunochemiluminescence. Results A total of 19 cases of Cushing’s disease (CD) and 1 case of ectopic CS were confirmed. In all cases, BIPSS provided accurate diagnostic guidance, with a sensitivity and specificity of 100%. In 8 patients, remission was not achieved after surgery. In 84% of catheterizations, ACTH ratio peaked at 3–6 min following stimulation. Patients with histologically-confirmed CD exhibited higher sinus ACTH ratios and values. Prolactin ratio helped us identify and exclude 28.6% of the samples with inconsistent results. Conclusions In our series, BIPSS combined with CRH stimulation demonstrated to be a safe, effective procedure. Prolactin emerges as a useful marker of correct catheterization. The participation of a multidisciplinary team is essential. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10197771&blobtype=pdf |
| Page Count | 6 |
| Volume Number | 3 |
| DOI | 10.1515/almed-2022-0088 |
| PubMed Central reference number | PMC10197771 |
| Issue Number | 3 |
| PubMed reference number | 37362143 |
| Journal | Advances in Laboratory Medicine [Adv Lab Med] |
| e-ISSN | 2628491X |
| Language | English |
| Publisher | De Gruyter |
| Publisher Date | 2022-10-03 |
| Access Restriction | Open |
| Rights License | This work is licensed under the Creative Commons Attribution 4.0 International License. © 2022 the author(s), published by De Gruyter, Berlin/Boston |
| Subject Keyword | bilateral inferior petrosal sinus sampling Cushing’s disease Cushing’s syndrome diagnostic utility study ectopic ACTH syndrome |
| Content Type | Text |
| Resource Type | Article |
| Subject | Education Medical Laboratory Technology Medicine |
