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Everything posted by nighthawk

  1. It's because desmopressin stimulates ACTH release in corticotrophs (normal cells) and in corticotrophinomas, i.e., tumor cells in the case of Cushing's disease. This effect has been shown to be higher in CD than in non-CD patients. However, I think the ability of the DDAVP test to discriminate between CD and non-CD is questionable, although I'm not too familiar with that area of the literature. What does your MRI say?
  2. This is a remarkable paper and has big implications for testing and the diagnostic algorithm, especially given who the authors are. The blunt takeaway is do not use salivary cortisol for adrenal Cushing's because it doesn't work. They recommend dex test instead but we know that test has problems too--yes, even in adrenal cases. It's not clear to me if this is generalizable to all mild Cushing's, nor does it appear like cyclical or episodic Cushing's was considered. The other thing is that the technically "better" assay (LCMS) has worse sensitivity than the older, cheaper one (EIA). This is the
  3. Wow 8.4 on the first try. These are textbook adrenal numbers. I hope your doctors come to their senses.
  4. Hi Amanda, Based on what you posted, this is a slam dunk. If they don't diagnose you quickly you should go elsewhere. The lit recommends removing anything over 4 cm. You actually have convincing biochemical evidence with a rather high UFC and concurrent low ACTH (<10 pg/mL). I'm assuming you're using Quest for the UFC since he said it's not 2x high. Most people don't get to 2x on LC/MS-MS with mild/adrenal Cushing's. Let us know the dex results. The cutoff is 1.8 ug/dL.
  5. nighthawk


    Yes, that is common.
  6. This would be a huge loss if the boards close. Surely there's a way to do site backup / archiving. I think the information here is much too valuable to lose forever.
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