Andereggen, Lukas; Gralla, Jan; Christ, Emanuel (2024). The diagnostic yield of inferior petrosal sinus sampling in Cushing syndrome in the era of ovine CRH shortage. Acta neurochirurgica, 166(167) Springer Vienna 10.1007/s00701-024-06058-2
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PURPOSE
The ovine corticotropin-releasing hormone (oCRH) stimulation test has been routinely used in the diagnostic work-up of ACTH-dependent Cushing syndrome (CS). With oCRH currently being out-of-stock in Europe, we aimed at evaluating the diagnostic performance of inferior petrosal sinus sampling (IPSS) without oCRH stimulation.
METHODS
We compared the values of 40 patients with ACTH-dependent CS and negative MRI findings in whom ACTH was measured before and after oCRH stimulation.
RESULTS
The ratio of central-to-peripheral ACTH measurement (IPS:P) before the combined 3, 5, and 10 min of oCRH stimulation yielded diminished sensitivity (85% vs. 97%), alongside markedly decreased specificity (57% vs. 71%), as well as reduced positive and negative predictive values (90% vs. 94% and 44% vs. 83%), respectively.
CONCLUSIONS
With the current drug shortages in Europe, ACTH measurements without oCRH stimulation in IPSS cannot be recommended. Thus, we call for desmopressin or the commercially available human CRH as a potential alternative in the confirmation of ACTH excess by IPSS in equivocal MRI findings.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Neurochirurgie |
UniBE Contributor: |
Andereggen, Lukas, Gralla, Jan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0001-6268 |
Publisher: |
Springer Vienna |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
03 Apr 2024 14:08 |
Last Modified: |
04 Apr 2024 04:01 |
Publisher DOI: |
10.1007/s00701-024-06058-2 |
PubMed ID: |
38565838 |
Uncontrolled Keywords: |
Cushing’s syndrome Drug shortages Petrosal sinus sampling oCRH stimulation |
BORIS DOI: |
10.48350/195567 |
URI: |
https://boris.unibe.ch/id/eprint/195567 |
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