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Journal of the Polish Society of Internal Medicine founded by professor Władysław Antoni Gluziński
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IC Value for 2009: 7.80 pts,
MNiSW Value: 9 pts.
The journal receives funding from the Ministry of Science and Higher Education for promoting scientific research.
Polish Archives of Internal Medicine is an open-access journal and does not charge readers for access to the full texts of the articles.
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Partner Polskiej Interny
The desmopressin test in the diagnosis of Cushing’s disease
Teresa Gasińska, Renata Dec, Hanna Wichary, Lidia Pietrasik, Grażyna Kulawik
Abstract
Introduction. Early and precise diagnosis is necessary in successful treatment of the patients with
Cushing’s disease. Transsphenoidal surgery is the first line treatment option in Cushing’s disease. In patients in
whom magnetic resonance imaging does not visualise pituitary adenoma patient selection for surgical treatment
should be based on convincing results of functional tests. Objectives. The diagnostic accuracy of the desmopressin
test was compared with that of the CRH test and the overnight high-dose dexamethasone suppression test in the
diagnosis of Cushing’s disease. Design and method. We studied 15 patients with pituitary-dependent Cushing’s
disease (10 with detected microadenoma and 5 with undetected microadenoma using magnetic resonance
imaging). The diagnosis was confirmed during pituitary surgery. The control group included 15 subjects without
Cushing’s syndrome. Patients underwent tests with desmopressin, CRH and 8 mg overnight dexamethasone.
Results. A false negative response to CRH was present in 1 of 15 patients, a false negative response to
dexamethasone was present in 1 of 15 patients and a false negative response to desmopressin in 2 of 15 patients.
In other patients positive responses to CRH, desmopressin and dexamethasone were found. A positive response
to desmopressin was present in 4 of 5 patients with undetected pituitary adenoma. In the control group a positive
response to CRH and dexamethazone and a negative response to desmopressin was found in all patients.
Conclusions 1.The highest diagnostic accuracy in the diagnosis of some patients with Cushing’s disease is achieved
by using a desmopressin test with high-dose dexamethasone test and CRH-test. 2. The desmopressin test can be
used to precisely identify healthy individuals.
Keywords
Cushing’s disease, desmopressin test
Pol Arch Med Wewn, 2007; 117 (1-2): 20-26
PMID: 17642202
