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Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease

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http://www.springerlink.com/content/d3n7j01m0m1l7t25/

 

Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: Effects of corticotropin-releasing factor and thyrotropin-releasing hormone on pituitary secretion

 

 

Thomas R. Strack1 Contact Information, Hans H. Schild2, Jurgen Bohl3, Jurgen Beyer1, Jurgen Schrezemeir1 and George Kahaly1

(1) Department of Internal Medicine and Endocrinology, Johannes Gutenberg University, R & D Building, Obere Zahlbacher Str. 63, D-55131 Mainz, Federal Republic of Germany

(2) Department of Radiology, Johannes Gutenberg University, Langenbeckstra?e 1, D-55131 Mainz, Federal Republic of Germany

(3) Department of Neuropathology, Johannes Gutenberg University, Langenbeckstra?e 1, D-55131 Mainz, Federal Republic of Germany

 

Abstract We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents?corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed production of both ACTH and prolactin in tumor cells, explaining the abnormal secretion pattern of the pituitary adenoma. The use of CRF and TRH may therefore improve the reliability of selective blood sampling and tests from the IPS in those cases of Cushing's disease for which noninvasive methods have otherwide failed to clarify the diagnosis.

 

Key words Pituitary neoplasms - Microadenoma - Cushing's syndrome - Angiography

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Am I reading this right? Sounds like they are saying that IPSS can be used to clairfy / make a cushings diagnosis where other tests have not given a clear cut picture.

 

Hmmm . . . . . this IS interesting.

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I'm not sure I completely understand all of it, but it sounds like this helps improve the IPS test's reliability.

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This is very interesting...my tumor was found to be secreting prolactin and ACTH. Apparently this is more common than originally thought!

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