Non-invasive Diagnostic Strategy in ACTH-dependent Cushing’s Syndrome
| dc.rights.license | open | en_US |
| hal.structure.identifier | CHU Bordeaux | |
| dc.contributor.author | FRETE, Caroline | |
| hal.structure.identifier | CHU Bordeaux | |
| hal.structure.identifier | Nutrition et Neurobiologie intégrée [NutriNeuro] | |
| dc.contributor.author | CORCUFF, Jean-Benoit
IDREF: 058708154 | |
| dc.contributor.author | KUHN, Emmanuelle | |
| dc.contributor.author | SALENAVE, Sylvie | |
| hal.structure.identifier | CHU Bordeaux | |
| dc.contributor.author | GAYE, Delphine | |
| dc.contributor.author | YOUNG, Jacques | |
| dc.contributor.author | CHANSON, Philippe | |
| hal.structure.identifier | CHU Bordeaux | |
| hal.structure.identifier | Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB] | |
| dc.contributor.author | TABARIN, Antoine | |
| dc.date.accessioned | 2024-01-09T15:57:14Z | |
| dc.date.available | 2024-01-09T15:57:14Z | |
| dc.date.issued | 2020-10-01 | |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/186984 | |
| dc.description.abstractEn | Context: Inferior petrosal sinus sampling (IPSS) is used to diagnose Cushing’s disease (CD) when dexamethasone-suppression and CRH tests, and pituitary magnetic resonance imaging (MRI), are negative or give discordant results. However, IPSS is an invasive procedure and its availability is limited. Objective: To test a noninvasive diagnostic strategy associated with 100% positive predictive value (PPV) for CD. Design: Retrospective study. Setting: Two university hospitals. Patients: A total of 167 patients with CD and 27 patients with ectopic ACTH-syndrome investigated between 2001 and 2016. Main Outcome Measure(s): Performance of a strategy involving the CRH and desmopressin tests with pituitary MRI followed by thin-slice whole-body computed tomography (CT) scan in patients with inconclusive results. Results: Using thresholds of a cortisol increase > 17% with an ACTH increase > 37% during the CRH test and a cortisol increase > 18% with an ACTH increase > 33% during the desmopressin test, the combination of both tests gave 73% sensitivity and 98% PPV of CD. The sensitivity and PPV for pituitary MRI were 71% and 99%, respectively. CT scan identified 67% EAS at presentation with no false-positives. The PPV for CD was 100% in patients with positive responses to both tests, with negative pituitary MRI and CT scan. The Negative Predictive Value was 100% in patients with negative responses to both tests, with negative pituitary MRI and positive CT scan. Using this strategy, IPPS could have been avoided in 47% of patients in whom it is currently recommended. Conclusions. In conjunction with expert radiologic interpretation, the non-invasive algorithm studied significantly reduces the need for IPSS in the investigation of ACTH-dependent Cushing’s syndrome. (J Clin Endocrinol Metab 105: 1–12, 2020) © Endocrine Society 2020. All rights reserved. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Cushing’s disease | |
| dc.subject.en | Ectopic ACTH-syndrome | |
| dc.subject.en | CRH test | |
| dc.subject.en | Desmopressin test | |
| dc.subject.en | CT scanning | |
| dc.subject.en | Bilateral inferior petrosal sinus sampling | |
| dc.title.en | Non-invasive Diagnostic Strategy in ACTH-dependent Cushing’s Syndrome | |
| dc.title.alternative | J Clin Endocrinol Metab | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1210/clinem/dgaa409 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Neurosciences [q-bio.NC] | en_US |
| dc.identifier.pubmed | 32594169 | en_US |
| bordeaux.journal | Journal of Clinical Endocrinology and Metabolism | en_US |
| bordeaux.page | 3273-3284 | en_US |
| bordeaux.volume | 105 | en_US |
| bordeaux.hal.laboratories | Neurocentre Magendie - U1215 | en_US |
| bordeaux.issue | 10 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.institution | Bordeaux INP | |
| bordeaux.institution | INRAE | |
| bordeaux.team | Physiopathologie de l'équilibre énergétique et obésité | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-04383322 | |
| hal.version | 1 | |
| hal.date.transferred | 2024-01-09T15:57:16Z | |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | true | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20Clinical%20Endocrinology%20and%20Metabolism&rft.date=2020-10-01&rft.volume=105&rft.issue=10&rft.spage=3273-3284&rft.epage=3273-3284&rft.au=FRETE,%20Caroline&CORCUFF,%20Jean-Benoit&KUHN,%20Emmanuelle&SALENAVE,%20Sylvie&GAYE,%20Delphine&rft.genre=article |
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