title: CRH test after pituitary microsurgery suggests tertiary adrenocortical insufficiency in successful operated patients with Cushing's disease.
abstract: 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.
authors.affiliation: Neurochirurgische Klinik, University of Erlangen-Nürberg, West Germany.
authors.forename: U
authors.initials: U
authors.lastname: Schrell
authors.forename: R
authors.initials: R
authors.lastname: Fahlbusch
authors.forename: M
authors.initials: M
authors.lastname: Buchfelder
authors.forename: S
authors.initials: S
authors.lastname: Riedl
authors.forename: G K
authors.initials: GK
authors.lastname: Stalla
authors.forename: O A
authors.initials: OA
authors.lastname: Müller
mesh_terms: 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*
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone