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Titolo:
EARLY POSTOPERATIVE EVALUATION IN PATIENTS WITH CUSHINGS-DISEASE - USEFULNESS OF OVINE CORTICOTROPIN-RELEASING HORMONE TEST IN THE PREDICTION OF RECURRENCE OF DISEASE
Autore:
VIGNATI F; BERSELLI ME; LOLI P;
Indirizzi:
OSPED NIGUARDA CA GRANDA,DIV ENDOCRINOL,PIAZZA OSPED MAGGIORE 3 I-20162 MILAN ITALY OSPED NIGUARDA CA GRANDA,DIV ENDOCRINOL I-20162 MILAN ITALY
Titolo Testata:
European journal of endocrinology
fascicolo: 3, volume: 130, anno: 1994,
pagine: 235 - 241
SICI:
0804-4643(1994)130:3<235:EPEIPW>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
PITUITARY SURGERY; MICROSURGERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
20
Recensione:
Indirizzi per estratti:
Citazione:
F. Vignati et al., "EARLY POSTOPERATIVE EVALUATION IN PATIENTS WITH CUSHINGS-DISEASE - USEFULNESS OF OVINE CORTICOTROPIN-RELEASING HORMONE TEST IN THE PREDICTION OF RECURRENCE OF DISEASE", European journal of endocrinology, 130(3), 1994, pp. 235-241

Abstract

In the attempt to identify parameters that might predict the risk of recurrence of Gushing's disease at an early stage after successful pituitary microsurgery, we evaluated retrospectively the usefulness of anearly postoperative determination of morning plasma and urinary cortisol levels and of adrenocorticotropin (ACTH) and cortisol responses toovine corticotropin-releasing hormone (oCRH) stimulation in 30 patients with pituitary-driven Cushing's disease followed up for 9 months to10 years after pituitary surgery. At an early postoperative evaluation, while off substitutive therapy, 30 patients, out of 36 treated by pituitary microsurgery for Cushing's disease, were considered in remission on the basis of subnormal (21 patients), low-normal (eight patients) or normal (one patient) morning plasma and urinary cortisol levels,whereas six patients with supranormal urinary cortisol excretion wereconsidered as surgical failures. The plasma ACTH response to oCRH wassubnormal (17 patients) or normal (four patients) in 21 patients (Group 1) and supranormal in nine patients (Group 2). All of the six patients with persistence of Gushing's disease had supranormal ACTH response to oCRH. Basal and oCRH-stimulated cortisol levels were subnormal in25 out of 30 patients considered in remission. During long-term evaluation, six patients had recurrence of Cushing's disease 9 months to 5 years after surgery; their early postoperative mean basal morning plasma and mean urinary cortisol were higher than those recorded in patients who did not relapse, although a wide overlap between subjects was evident. In five out of these six patients urinary cortisol excretion had decreased to almost undetectable values during low-dose dexamethasone. One patient was among the 21 of Group 1 and five among those of Group 2. The different rate of recurrence between the two groups was significant. We conclude that the finding of ACTH hyperresponsiveness to an early postoperative CRH test seems to be a valuable criterion for identifying patients with higher risk of recurrence of Gushing's disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/08/20 alle ore 20:51:13