Adrenocorticotropic Hormone-Dependent Cushing’s Syndrome Use of an octreotide trial to distinguish between pituitary or ectopic sources
Journal Title: Sultan Qaboos University Medical Journal - Year 2015, Vol 15, Issue 1
Abstract
Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. Tis study aimed to develop a simple non-invasive technique to differentiate these sources. Methods: Tis study took place in King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, and Sultan Qaboos University Hospital, Muscat, Oman, between 1988 and 2012. Serum cortisol levels were measured in nine patients with ACTH-dependent Cushing’s syndrome before and during a 72-hour trial of octreotide. All patients underwent computed tomography (CT) scans. MRI scans were performed on six patients. Results: CT scans were abnormal in three patients with ectopic ACTH production. MRI scans showed that three patients had pituitary microadenomas. Serum cortisol levels returned to normal in those with confrmed ectopic ACTH production. No response was found in the other six patients. Conclusion: A 72-hour trial of octreotide is recommended for patients with ACTH-dependent Cushing’s syndrome and a normal pituitary MRI. Tis trial will be a useful alternative to petrosal sinus sampling.
Authors and Affiliations
Omayma T. El-Shafe| Department of Medicine, Sultan Qaboos University Hospital, Nooralddin Al-Saf| Department of Medicine, Sultan Qaboos University Hospital, Ahmed Al-Sajwani| Department of Medicine, Royal Hospital, Muscat, Oman, Nicholas Woodhouse| Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
Keywords
Related Articles
- EP ID EP14541
- DOI -
- Views 289
- Downloads 11
Interprofessional Education (IPE) Activity amongst Health Sciences Students at Sultan Qaboos University The time is now!
Historically, health professionals have been educated in profession-specifc institutions which provide limited opportunities for learning interprofessional (IP) skills. Many qualifed practitioners are therefore poorly...
Are Men from Mars and Women from Venus? Bridging the gender learning gap in medical education
Acute Idiopathic Pulmonary Haemorrhage in a 2 month old Infant Case report and review of the literature
Pulmonary haemorrhage is usually secondary to a systemic disease affecting the lung with or without other organ involvement. Idiopathic pulmonary haemorrhage is a diagnosis of exclusion; as described in the literature,...
Snoring-Induced Nerve Lesions in the Upper Airway
Te prevalence of habitual snoring is extremely high in the general population, and is reported to be roughly 40% in men and 20% in women. Te low-frequency vibrations of snoring may cause physical trauma and, more speci...
Predictors of Human Immunodefciency Virus Knowledge among Jordanian Youths
Objectives: Understanding factors associated with the level of human immunodefciency virus (HIV) knowledge acquisition is crucial to inform preventative programmes for young people. Tis study examines predictors of HIV...