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dc.rights.licenseopenen_US
hal.structure.identifierHôpital Haut-Lévêque [CHU Bordeaux]
dc.contributor.authorCAMBOS, Sophie
hal.structure.identifierHôpital Haut-Lévêque [CHU de Bordeaux]
dc.contributor.authorMOHAMMEDI, Kamel
hal.structure.identifierAssistance Publique - Hôpitaux de Marseille [APHM]
dc.contributor.authorCASTINETTI, Frederic
hal.structure.identifierAssistance publique - Hôpitaux de Paris (AP-HP) [AP-HP]
dc.contributor.authorSAIE, Clothilde
hal.structure.identifierHôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
dc.contributor.authorYOUNG, Jacques
hal.structure.identifierHôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
dc.contributor.authorCHANSON, Philippe
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorTABARIN, Antoine
dc.date.accessioned2023-11-06T13:46:09Z
dc.date.available2023-11-06T13:46:09Z
dc.date.issued2020-05
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/184625
dc.description.abstractEnObjective: Cushing's disease (CD) may recur despite corticotropic insufficiency (COI) following pituitary surgery. The predictive value of the desmopressin test (DT) for recurrence in this setting remains controversial. We have evaluated whether the disappearance of the response to DT predicts a low probability recurrence in a large cohort of patients with post-operative COI. Design: Multicentre retrospective study. Methods: Ninety-five patients with CD (women 82%, age 41 ± 14 years), responding preoperatively to DT and with early post-operative COI (08 00 am cortisol: <138 nmol/L), underwent a DT within 3 months post-surgery. Association between DT findings and the prediction of recurrence was tested using regression and ROC analyses. Results: Recurrence occurred in 17/95 patients within 29 to 91 months. The cortisol peak (327, 95% CI (237-417) vs 121 (79-164) nmol/L, P = 0.0001) and absolute increment during DT (208 (136-280) vs 56 (22-90) nmol/L, P = 0.005) were greater in the recurrence vs remission group. Cortisol peak (AUC: 0.786 (0.670-0.902)) and increment (0.793 (0.672- 0.914)) yielded a higher prognostic performance for recurrence than did the early post-operative 08 00 am cortisol (0.655 (0.505-0.804)). In the context of COI, cortisol peak >100 nmol/L and increment >30 nmol/L had a high negative predictive value (94, 95% CI (88-100) and 94, (88-100), respectively). Patients with a cortisol peak ≤100 nmol/L (vs >100) or an increment ≤30 nmol/L (vs >30) were less likely to have CD recurrence (odds ratios: 0.12, 95% CI (0.03-0.41) and 0.11 (0.02-0.36), respectively). Conclusion: The disappearance of the response to the post-operative DT was independently associated with a lower odds of CD recurrence and offers an incremental prognostic value, which may help to stratify patients with COI and refine their follow-up according to the risk of recurrence. © 2020 European Society of Endocrinology.
dc.language.isoENen_US
dc.subject.enCorticotropin
dc.subject.enDesmopressin
dc.subject.enHydrocortisone
dc.subject.enAntidiuretic Agent
dc.subject.enArgipressin[1 Deamino]
dc.subject.enHydrocortisone
dc.subject.enAdult
dc.subject.enCohort Analysis
dc.subject.enCorticotropin Blood Level
dc.subject.enCorticotropin Deficiency
dc.subject.enCushing Disease
dc.subject.enDiagnostic Test Accuracy Study
dc.subject.enEndocrine Function Test
dc.subject.enFemale
dc.subject.enHuman
dc.subject.enHydrocortisone Blood Level
dc.subject.enMajor Clinical Study
dc.subject.enMale
dc.subject.enPostoperative Complication
dc.subject.enPredictive Value
dc.subject.enPreoperative Period
dc.subject.enPriority Journal
dc.subject.enPrognosis
dc.subject.enReceiver Operating Characteristic
dc.subject.enRecurrent Disease
dc.subject.enRemission
dc.subject.enRetrospective Study
dc.subject.enSensitivity And Specificity
dc.subject.enTranssphenoidal Surgery
dc.subject.enBlood
dc.subject.enClinical Trial
dc.subject.enCushing Disease
dc.subject.enFollow Up
dc.subject.enMiddle Aged
dc.subject.enMulticenter Study
dc.subject.enPostoperative Complication
dc.subject.enRecurrent Disease
dc.subject.enAntidiuretic Agents
dc.subject.enDeamino Arginine Vasopressin
dc.subject.enFollow-Up Studies
dc.subject.enHumans
dc.subject.enHydrocortisone
dc.subject.enMiddle Aged
dc.subject.enPituitary Acth Hypersecretion
dc.subject.enPostoperative Complications
dc.subject.enPredictive Value Of Tests
dc.subject.enRecurrence
dc.subject.enRetrospective Studies
dc.title.enPersistent cortisol response to desmopressin predicts recurrence of Cushing's disease in patients with post-operative corticotropic insufficiency
dc.title.alternativeEur J Endocrinolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1530/EJE-19-0770en_US
dc.subject.halSciences du Vivant [q-bio]/Neurosciences [q-bio.NC]en_US
dc.identifier.pubmed32187576en_US
bordeaux.journalEuropean Journal of Endocrinologyen_US
bordeaux.page489-498en_US
bordeaux.volume182en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - U1215en_US
bordeaux.issue5en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamPhysiopathologie de l'équilibre énergétique et obésitéen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04272097
hal.version1
hal.date.transferred2023-11-06T13:46:11Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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