Desmopressin test

[Guest Gsmwilder]

Hi, I had the desmopressin (DDAVP) stimulation test done last week, and my ACTH levels were all double the top of range, but the cortisols were normal. Outside of all the Cushing’s symptoms, my only other abnormal tests were a urine and 2 midnight salivas each a little over range, and high DHEA. (have had lots of “normal” tests)

Why would ACTH be so high? 

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[~MaryO~ 516]

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[Jklcpt 3]

Do you mean dexamethasone suppression test?

[nighthawk 70]

On 1/31/2021 at 4:28 PM, Guest Gsmwilder said:

Why would ACTH be so high? 

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?