[Basal cortisol and ACTH in the immediate postoperative period in ACTH-producing hypophyseal adenomas].
BACKGROUND
Evaluate the usefulness of basal cortisol and ACTH during the immediate postoperative period following hypophyseal surgery, as early indicators of remission in patients with Cushing's disease.


METHODS
Nine patients with Cushing's disease and on whom selective transphenoidal adenomectomy was performed were included in the study. Basal cortisol and ACTH levels were compared the first week after surgery, with definitive results being obtained after a month's time during which basal cortisol levels below 165 nmol/l indicated patients cured of Cushing's disease.


RESULTS
Cortisol levels determined post-op, in five patients in remission, were found to be lower than those in patients who were not cured (63 +/- 55.8 versus 606 +/- 267 nmol/l, p < 0.01). However, ACTH levels were not lower. All the patients in remission had initial cortisol levels lower than 182 nmol/l, whereas the uncured patients had levels higher than 404 nmol/l. There was a correlation between cortisol measured in the first week and the definitive value (r = 0.81, p < 0.01).


CONCLUSIONS
Cortisol in the immediate postoperative period following hypophyseal surgery is a good indicator of definitive adrenocorticotropic function and permits the identification of those patients in remission.
Gómez
J M
JM
Servicio de Endocrinologío, Ciutat Sanitària i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona.
Camps
I
I
Villabona
C
C
Leyes
P
P
Montaña
E
E
Bonnin
R
R
Soler
J
J
D000236:Adenoma / Q000378:metabolism* / Q000601:surgery; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood* / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D002648:Child; D003346:Corticotropin-Releasing Hormone; D003480:Cushing Syndrome / Q000378:metabolism / Q000601:surgery; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007016:Hypophysectomy; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000378:metabolism* / Q000601:surgery; D011184:Postoperative Period
D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone
Interés del cortisol y ACTH basales en el postoperatorio inmediato de adenomas hipofisarios productores de ACTH.