Diagnostic insights from twenty years of bilateral inferior petrosal sinus sampling for Cushings Disease at Mayo Clinic (1998-2018)
O'Keeffe, Derek
O'Keeffe, Derek
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http://hdl.handle.net/10379/15823
https://doi.org/10.13025/17673
https://doi.org/10.13025/17673
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Publication Date
2020-03-02
Type
Thesis
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Abstract
Pituitary-dependent Cushing syndrome (CS), referred to herein as Cushing Disease (CD), is the most common cause of endogenous CS. The challenge for diagnosing CD includes difficulty identifying the often small pituitary tumors by MRI. In addition, the tumors responsible for Ectopic Adrenocorticotropic Hormone (ACTH) dependent CS (EADCS) may also be difficult to localize by imaging. Bilateral Inferior Petrosal Sinus Sampling (BIPSS) plays a key role in these patients to determine if the source of ACTH hypersecretion is CD or EADCS. This MD thesis work reviewed in detail, 20 years of BIPSS clinical cases at the Mayo Clinic Rochester MN USA (1998-2018) and determined the efficacy of BIPSS in the diagnosis of CD. In addition it also compared the diagnostic accuracy of BIPSS versus Bilateral Internal Jugular Venous Sampling (BIJVS) and correspondingly examined the ability of the periperhal ovine Corticotropin Releasing Hormone (oCRH) stimulation test to distinguish between CD and EADCS.
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Publisher
NUI Galway
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Attribution-NonCommercial-NoDerivs 3.0 Ireland