A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24- hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH) level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS) was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.
Abstract
A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24- hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH) level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS) was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.
참고문헌 (9)
- Melmed S, "Williams textbook of endocrinology", pp.2011, Saunders
- Savage MO, "Work-up and management of paediatric Cushing's syndrome", Curr Opin Endocrinol Diabetes Obes, 15, pp.346~351 (2008)
- Boscaro M, "Approach to the patient with possible Cushing's syndrome", J Clin Endocrinol Metab, 94, pp.3121~3131 (2009)
- Pecori Giraldi F, "The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology", Neurosurg Focus, 38, pp.E5~ (2015)
- Lad SP, "The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease", Neurosurg Focus, 23, pp.E2~ (2007)
- Deipolyi AR, "Bilateral inferior petrosal sinus sampling using desmopressin or corticotropic-releasing hormone: a single-center experience", J Neurointerv Surg, 7, pp.690~693 (2015)
- Castinetti F, "Desmopressin test during petrosal sinus sampling: a valuable tool to discriminate pituitary or ectopic ACTH-dependent Cushing's syndrome", Eur J Endocrinol, 157, pp.271~277 (2007)
- Luque RM, "A cellular and molecular basis for the selective desmopressin-induced ACTH release in Cushing disease patients: key role of AVPR1b receptor and potential therapeutic implications", J Clin Endocrinol Metab, 98, pp.4160~4169 (2013)
- Pecori Giraldi F, "Von Willebrand factor and fibrinolytic parameters during the desmopressin test in patients with Cushing's disease", Br J Clin Pharmacol, 71, pp.132~136 (2011)