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...

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Bibliographic Details
Published in:International Journal of Endocrinology 2015-01, Vol.2015 (2015), p.761-768-084
Main Authors: Witek, Przemysław, Szamotulska, Katarzyna, Zieliński, Grzegorz
Format: Article
Language:English
Subjects:
Care and treatment
Circadian rhythm
Clinical Study
Cushing syndrome
Dexamethasone
Diagnosis
Endocrinology
Hormones
Hypotheses
Magnetic resonance imaging
Patients
Physiological aspects
Pituitary gland
Plasma
Statistical analysis
Steroids
Surgery
Tumors
Values
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Summary: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
ISSN:1687-8337
1687-8345
DOI:10.1155/2015/357165