| Autor: |
Findling, James W., Aron, David C., Tyrrell, J. Blake, Shinsako, Jeanette H., Fitzgerald, Paul A., Norman, David, Wilson, Charles B., Forsham, Peter H., Findling, J W, Aron, D C, Tyrrell, J B, Shinsako, J H, Fitzgerald, P A, Norman, D, Wilson, C B, Forsham, P H |
| Předmět: |
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| Zdroj: |
Annals of Internal Medicine; May81, Vol. 94 Issue 5, p647-652, 6p, 2 Charts, 1 Graph |
| Abstrakt: |
We performed selective venous catheterization and sampling for ACTH in six patients with ACTH-secreting pituitary adenomas (Cushing's disease) and four patients with occult ectopic ACTH-secreting neoplasms. In five patients with Cushing's disease in whom the inferior petrosal sinus could be catheterized, ACTH levels were unequivocally higher than simultaneous peripheral values: The ratio was greater than 2.0, with a range of 2.2 to 16.7. In contrast, the inferior petrosal sinus-to-peripheral ACTH ratio in three patients with ectopic ACTH secretion was less than 1.5. In the fourth patient, an arteriovenous gradient of 6.8 was shown 2 years before a bronchial carcinoid tumor was clinically apparent. Central-to-peripheral ACTH ratios at the level of the jugular bulb and jugular vein were not diagnostic. We conclude that selective venous ACTH sampling from the inferior petrosal sinus is a reliable and useful aid in the differential diagnosis of Cushing's syndrome when standard clinical and biochemical studies are inconclusive. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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