The ovine corticotropin-releasing hormone stimulation test in the differential diagnosis of adrenocorticotropic hormone-dependent cushing's syndrome.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Neena Natt, W F Young

Abstract

To determine the efficacy of the ovine corticotropin-releasing hormone (oCRH) stimulation test in distinguishing between adrenocorticotropic hormone (ACTH)-dependent types of Cushing's syndrome. The cortisol and ACTH responses to intravenously administered oCRH were determined in 64 patients with pituitary-dependent Cushing's syndrome and 13 patients with ectopic ACTH production. Of the 64 patients with pituitary-dependent Cushing's syndrome, 57 (89%) had a positive ACTH response to administration of oCRH (an increase of 50% or more above baseline), and 56 (88%) had a positive cortisol response (an increase of 20% or more above baseline). One patient with an ectopic ACTH-secreting tumor had a false-positive cortisol response to administration of oCRH. Two patients with ectopic ACTH-secreting tumors had false-positive responses to both ACTH and cortisol after oCRH was administered. Because both these patients did not have hypercortisolemia at the time of testing, they were excluded from the statistical analysis. When analyzed on the basis of ACTH response alone, oCRH testing yielded a diagnostic sensitivity and specificity for the diagnosis of pituitary-dependent hypercortisolism of 89% and 100%, respectively. The positive predi...Continue Reading

References

Jul 1, 1990·Mayo Clinic Proceedings·W F YoungP C Carpenter
Mar 15, 1990·Annals of Internal Medicine·T B Kaye, L Crapo
Nov 1, 1988·The Journal of Clinical Endocrinology and Metabolism·S A WestphalJ H Oppenheimer
Nov 1, 1986·The Journal of Clinical Endocrinology and Metabolism·T SudaT Sumitomo
Jul 1, 1983·The Journal of Clinical Endocrinology and Metabolism·O A MüllerK von Werder

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Citations

Jan 16, 1998·Endocrinology and Metabolism Clinics of North America·S M Ness, W F Young
Aug 22, 2009·Journal of Oncology·Daris FerrariPaolo Foa

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