A Clinical study on the diagnesis and Treatment of Cushing's Disease
- Author:
Seong Yeon KIM
;
Kyung Soo PARK
;
Bo Youn CHO
;
Hong Kyu LEE
;
Jae Seok JEON
;
Hyeong Kyu PARK
;
Chang Soon KOH
;
Hun Ki MIN
;
Heu Won JEONG
;
Dae Hee HAN
;
Moon Hee HAN
;
Kee Hyun JANG
- Publication Type:Original Article
- Keywords:
Inferior petrosal sinus sampling;
Cushing's disease
- MeSH:
Adrenocorticotropic Hormone;
Clinical Study;
Cushing Syndrome;
Diagnosis, Differential;
Petrosal Sinus Sampling
- From:Journal of Korean Society of Endocrinology
1994;9(2):115-120
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Bilateral inferior petrosal sinus sampling(IPSS) is known to be useful for the differential diagnosis of ACTH-dependent Cushing's syndrome and for the preoperative localization of pituitary microadenomas.To evaluate the usefulness of IPSS, we performed the procedure in the 17 cases of ACTH-dependent Cushing's syndrome including 2 cases of macroadenomas, 6 of them with CRH stimulation test. A inferior petrosal sinus-to-peripheral ACTH ratio of 2:1 or greater(3:1 after CRH stimulation) indicates a pituitary source of ACTH hypersecretion, and a ratio of the ACTH level in one inferior petrosal sinus to the ACTH level in the other of 1:4 or greater lateralizes the microadenomas to that half of the pituitary gland.With these criteria, we diagnosed Cushing's disease in 15 of 17 cases of ACTH-dependent Cushing's syndrome, and localized the lesion in 8 of 13 cases of microadenoma.In conclusion, IPSS with CRH stimulation has high diagnostic accuracy in the differential diagnosis of ACTH-dependent Cushing's syndrome, but still has the limitations on the localization of microadenoma.
