A combined test using desmopressin and corticotropin-releasing hormone in the differential diagnosis of Cushing's syndrome

The Journal of Clinical Endocrinology and Metabolism
J D Newell-PriceA Grossman

Abstract

To assess the ability of desmopressin to differentiate between pituitary and ectopic ACTH-dependent Cushing's syndrome and to determine whether diagnostic accuracy could be improved by administering it together with human sequence CRH, we examined its effects on cortisol and ACTH secretion when given alone or in combination with CRH in patients with Cushing's syndrome of varied etiology and compared these data to the results of a standard CRH test in the same individuals. Each patient was studied on three occasions, in random order, separated by at least 48 h. At 0900 h, via an indwelling forearm cannula, 10 micrograms desmopressin, 100 micrograms CRH, or a combination of the two were given as an iv bolus; thereafter, blood was drawn every 15 min for 2 h. The responses to the individual agents were determined according to the timing and calculation criteria suggested by Nieman et al. (1993). A total of 25 patients with Cushing's syndrome were studied: 17 patients with pituitary-dependent Cushing's syndrome, Cushing's disease (CD); 5 patients with occult ectopic ACTH secretion (EC); and 3 patients with primary adrenal (ACTH-independent) Cushing's syndrome. In this series, the best discrimination among ACTH-dependent patient grou...Continue Reading

Citations

Apr 9, 2002·Current Neurology and Neuroscience Reports·Paul L PenarAfshin Salsali
Jun 18, 2010·Reviews in Endocrine & Metabolic Disorders·Dima AbdelMannanBaha M Arafah
Nov 24, 2007·Pituitary·Blerina Kola, Ashley B Grossman
Nov 7, 2003·The Journal of Clinical Endocrinology and Metabolism·Andrea M IsidoriAshley B Grossman
Nov 4, 2000·The Journal of Clinical Endocrinology and Metabolism·M MoroF Cavagnini
Feb 24, 2018·European Journal of Endocrinology·Dimitra Argyro Vassiliadi, Stylianos Tsagarakis
Apr 16, 1999·Endocrine Reviews·P L Dahia, A B Grossman
Dec 4, 2019·Frontiers in Endocrinology·José Miguel Hinojosa-AmayaMaria Fleseriu
Dec 14, 1999·Clinical Endocrinology·L V ScottT G Dinan

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