6533b829fe1ef96bd128af15

RESEARCH PRODUCT

Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: effects of corticotropin-releasing factor and thyrotropin-releasing hormone on pituitary secretion.

Thomas StrackJürgen BeyerJurgen SchrezemeirGeorge J. KahalyHans H. SchildJürgen Bohl

subject

Maleendocrine systemPituitary glandmedicine.medical_specialtyCorticotropin-Releasing HormoneThyrotropin-releasing hormonePituitary neoplasmPetrosal Sinus SamplingSensitivity and SpecificityCushing syndromeAdrenocorticotropic HormonePituitary Gland AnteriorInternal medicinemedicineHumansRadiology Nuclear Medicine and imagingPituitary NeoplasmsCushing SyndromeThyrotropin-Releasing Hormonebusiness.industryInferior petrosal sinusCushing's diseasemedicine.diseaseProlactinProlactinmedicine.anatomical_structureEndocrinologyFemaleCardiology and Cardiovascular Medicinebusinesshormones hormone substitutes and hormone antagonistsBlood sampling

description

We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents--corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed production of both ACTH and prolactin in tumor cells, explaining the abnormal secretion pattern of the pituitary adenoma. The use of CRF and TRH may therefore improve the reliability of selective blood sampling and tests from the IPS in those cases of Cushing's disease for which noninvasive methods have otherwise failed to clarify the diagnosis.

yearjournalcountryeditionlanguage
1993-09-01Cardiovascular and interventional radiology
10.1007/bf02629159https://pubmed.ncbi.nlm.nih.gov/8269424