CRH test after pituitary microsurgery suggests tertiary adrenocortical insufficiency in successful operated patients with Cushing's disease.
In this study 30 patients with ACTH-dependent Cushing's disease underwent CRH-stimulation test before, 7-10 days and 3-6 months later after transphenoidal selective microadenomectomy. In 22 of 30 patients clinical and endocrinological remission (2 mg dexamethasone suppression test below 2 micrograms/dl cortisol) occurred. Fourteen of the 22 patients in remission showed a statistically significant increase of ACTH after CRH, 1 week after the operation. This CRH-induced ACTH increase in the early post-operative period gives indirect evidence for endogenous CRH deficiency and suggests tertiary adrenocortical insufficiency in successfully operated patients.
Schrell
U
U
Neurochirurgische Klinik, University of Erlangen-Nürberg, West Germany.
Fahlbusch
R
R
Buchfelder
M
M
Riedl
S
S
Stalla
G K
GK
Müller
O A
OA
D000236:Adenoma / Q000150:complications / Q000601:surgery*; D000302:Adrenal Cortex / Q000503:physiopathology; D000309:Adrenal Insufficiency / Q000209:etiology* / Q000503:physiopathology; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D003346:Corticotropin-Releasing Hormone; D003480:Cushing Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008866:Microsurgery; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery*
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone