CRH and lysine-vasopressin stimulation tests in the diagnosis of hypoadrenalism secondary to hypothalamic or pituitary disorders.
Ten patients with secondary hypoadrenalism have been tested with corticotropin releasing hormone (CRH) and lysine-vasopressin (LVP). One patient had isolated ACTH deficiency; 9 had deficiency of other pituitary hormones attributable to a primary pituitary disease in 3 and to an hypothalamic disorder in 6. After CRH administration, a definite increase in plasma ACTH was observed in all 6 patients with hypothalamic disorder. No response was elicited in the 3 patients with pituitary disease and in the patient with isolated ACTH deficiency. In the responsive patients. ACTH showed a delayed and prolonged pattern of response. Lysine-vasopressin administration produced an increase in plasma ACTH in 4 of the 6 hypothalamic patients and no response in those with pituitary disease and in the patient with isolated ACTH deficiency. These findings suggest that CRH represents a reliable test in differentiating hypothalamic from pituitary adrenal failure; LVP appeared a less sensitive diagnostic test.
Cantalamessa
L
L
Semeiotica Medica I, Università di Milano, Ospedale Maggiore, Italy.
Catania
A
A
Baldini
M
M
Orsatti
A
A
Motta
P
P
Peracchi
G
G
D000293:Adolescent; D000308:Adrenocortical Hyperfunction / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000172:deficiency; D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000494:pharmacology; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008236:Lypressin / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D010912:Pituitary-Adrenal Function Tests / Q000379:methods
D008236:Lypressin; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone