Desmopressin is a safe and effective secretagogue to replace corticotropin-releasing hormone in petrosal sinus sampling - 03/04/25
Abstract |
Purpose |
Bilateral inferior petrosal sinus sampling (BIPSS) with corticotropin-releasing hormone (CRH) was the gold standard for distinguishing Cushing disease (CD) from ectopic ACTH secretion (EAS). CRH, however, is no longer available.
Objective |
To assess the reliability of BIPSS with desmopressin to differentiate CD from EAS.
Methods |
A retrospective study included patients who underwent BIPSS with desmopressin for ACTH-dependent hypercortisolism, with the whole diagnostic procedure in a single center.
Results |
Fifty-eight patients with confirmed etiological diagnosis were included: 51 CD, 7 EAS. Forty-three CD patients (84.3%) had post-stimulation ratio ≥2 before stimulation and 6 of the other 8 (75%) had a ratio ≥3. All EAS patients were correctly diagnosed before and after stimulation. Sensitivity was 84.3% before stimulation and 92.2% combining pre- and post-stimulation results; specificity reached 100%. A ROC curve established optimal thresholds at 1.4 before stimulation and 1.7 after.
Conclusion |
Desmopressin is a good substitute for CRH, correcting diagnosis compared to baseline BIPSS in 12% of cases.
Le texte complet de cet article est disponible en PDF.Keywords : Pituitary, Cushing disease, Ectopic ACTH secretion, Bilateral inferior petrosal sinus sampling, Desmopressin
Plan
Vol 86 - N° 2
Article 101678- avril 2025 Retour au numéro
Article précédent
- Impact of therapeutic doses of prednisolone and other glucocorticoids on insulin secretion from human islets
- Omolara Khadijat Tijani, Maria Moreno-Lopez, Isaline Louvet, Ana Acosta-Montalvo, Anaïs Coddeville, Valery Gmyr, Julie Kerr-Conte, François Pattou, Marie-Christine Vantyghem, Chiara Saponaro, Caroline Bonner, Stéphanie Espiard
- Increased cardiovascular risk despite unchanged body composition in non functional adrenal incidentaloma
- Alperen Boyraz, Burcu Candemir, Şafak Akın, Mustafa Candemir, Neşe Ersöz Gülçelik
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?