Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation
Background. The risk of Cushing’s disease (CD) recurring may persist for years, even after initially successful surgery. Objective. To prospectively assess the relevance of a combined dexamethasone desmopressin test (CDDT) as a component of postoperative hormonal evaluation, including the dynamics o...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/357165 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850176498997133312 |
|---|---|
| author | Przemysław Witek Grzegorz Zieliński Katarzyna Szamotulska |
| author_facet | Przemysław Witek Grzegorz Zieliński Katarzyna Szamotulska |
| author_sort | Przemysław Witek |
| collection | DOAJ |
| description | Background. The risk of Cushing’s disease (CD) recurring may persist for years, even after initially successful surgery. Objective. To prospectively assess the relevance of a combined dexamethasone desmopressin test (CDDT) as a component of postoperative hormonal evaluation, including the dynamics of ACTH and cortisol concentrations. Material and Methods. We included 28 patients after TSS for CD. Eighteen months after surgery the standard hormonal evaluation was performed, followed by a CDDT. Results. Fifteen patients (53.6%) were in remission whereas in 13 subjects (46.4%) hypercortisolemia was confirmed. Positive results of CDDT were observed in 12 noncured patients (92.3%) and in one subject in remission (6.7%). Negative results were obtained in 12 patients with remission (80%) and in one noncured patient (7.7%). With 2 patients in CD remission (13.3%) the test results were inconclusive. We confirmed a high compatibility between CDDT and standard hormonal assessment results (κ=0.846; P<0.001). Significant differences in ACTH and cortisol levels at each CDDT time point between the two studied subgroups were shown. Conclusions. A negative CDDT result can be regarded as one of the factors indicative of CD remission during follow-up. Additionally, CDDT can help distinguish persistent hypercortisolemia from naturally recurring adrenal function after TSS. |
| format | Article |
| id | doaj-art-c1b7be92617a4fdcaabb2f9c4e982d65 |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-c1b7be92617a4fdcaabb2f9c4e982d652025-08-20T02:19:15ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/357165357165Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal EvaluationPrzemysław Witek0Grzegorz Zieliński1Katarzyna Szamotulska2Department of Endocrinology and Isotope Therapy, Military Institute of Medicine, Ul. Szaserów 128, 04-141 Warsaw, PolandDepartment of Neurosurgery, Military Institute of Medicine, Ul. Szaserów 128, 04-141 Warsaw, PolandDepartment of Epidemiology, Institute of Mother and Child, Ul. Kasprzaka 17a, 01-211 Warsaw, PolandBackground. The risk of Cushing’s disease (CD) recurring may persist for years, even after initially successful surgery. Objective. To prospectively assess the relevance of a combined dexamethasone desmopressin test (CDDT) as a component of postoperative hormonal evaluation, including the dynamics of ACTH and cortisol concentrations. Material and Methods. We included 28 patients after TSS for CD. Eighteen months after surgery the standard hormonal evaluation was performed, followed by a CDDT. Results. Fifteen patients (53.6%) were in remission whereas in 13 subjects (46.4%) hypercortisolemia was confirmed. Positive results of CDDT were observed in 12 noncured patients (92.3%) and in one subject in remission (6.7%). Negative results were obtained in 12 patients with remission (80%) and in one noncured patient (7.7%). With 2 patients in CD remission (13.3%) the test results were inconclusive. We confirmed a high compatibility between CDDT and standard hormonal assessment results (κ=0.846; P<0.001). Significant differences in ACTH and cortisol levels at each CDDT time point between the two studied subgroups were shown. Conclusions. A negative CDDT result can be regarded as one of the factors indicative of CD remission during follow-up. Additionally, CDDT can help distinguish persistent hypercortisolemia from naturally recurring adrenal function after TSS.http://dx.doi.org/10.1155/2015/357165 |
| spellingShingle | Przemysław Witek Grzegorz Zieliński Katarzyna Szamotulska Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation International Journal of Endocrinology |
| title | Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation |
| title_full | Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation |
| title_fullStr | Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation |
| title_full_unstemmed | Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation |
| title_short | Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation |
| title_sort | cushing s disease the relevance of a combined dexamethasone desmopressin test as a component of postoperative hormonal evaluation |
| url | http://dx.doi.org/10.1155/2015/357165 |
| work_keys_str_mv | AT przemysławwitek cushingsdiseasetherelevanceofacombineddexamethasonedesmopressintestasacomponentofpostoperativehormonalevaluation AT grzegorzzielinski cushingsdiseasetherelevanceofacombineddexamethasonedesmopressintestasacomponentofpostoperativehormonalevaluation AT katarzynaszamotulska cushingsdiseasetherelevanceofacombineddexamethasonedesmopressintestasacomponentofpostoperativehormonalevaluation |