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17th European Congress of Endocrinology

Guided Posters

Pituitary – Diagnosis of Cushing's disease

ea0037gp.21.01 | Pituitary – Diagnosis of Cushing's disease | ECE2015

A reappraisal of second line tests in the differential diagnosis of ACTH-dependent Cushing's syndrome: the role of three dynamic tests

Barbot Mattia , Trementino Laura , Ceccato Filippo , Zilio Marialuisa , Albiger Nora , Boscaro Marco , Arnaldi Giorgio , Scaroni Carla

Introduction: The diagnosis of Cushing’s syndrome (CS) might be challenging especially in ACTH-dependent CS when it comes to detect the origin of ACTH secretion.Materials and methods: We retrospectively recorded data about 170 patients with ACTH-dependent CS (149 CD, 21 EAS) referring to two Endocrinology Units. We focused especially on the performance of 3 dynamic tests: the dexamethasone 8 mg overnight challenging (HDDST), the CRH and the desmopre...

ea0037gp.21.02 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Bilateral inferior petrosal sinus sampling reliably differentiates pituitary from ectopic Cushing's, but frequently fails to predict pituitary tumour location, especially when lateralizing to the right

Koulouri Olympia , Nigam Nishita , Powlson Andrew , Donnelly Neil , Mannion Richard , Pickard John , Koo Brendan , Halsall David , Gurnell Mark

Background: BIPSS remains the gold standard for differentiating pituitary and ectopic sources in ACTH-dependent Cushing’s syndrome. A pituitary:peripheral ACTH ratio >2 in the basal state, and/or >3 following CRH stimulation, is considered indicative of pituitary Cushing’s, with a range of sensitivities and specificities cited in the literature. In addition, in Cushing’s disease a peak interpetrosal gradient of >1.4 has been reported to predict the s...

ea0037gp.21.03 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Altered neural processing during emotional faces in remitted Cushing's disease

Andela Cornelie , Hoogendam Janna Marie , Van der Werff Steven , Pannekoek Nienke , Van Steenbergen Henk , Meijer Onno , Van Buchem Mark , Rombouts Serge , Van der Mast Roos , Biermasz Nienke , Van der Wee Nic , Pereira Alberto

Background: Patients with long-term remission of Cushing’s disease (CD) demonstrate residual psychological complaints. At present, it is not known how previous exposure to hypercortisolism affects psychological functioning in the long-term. In foregoing Magnetic Resonance Imaging (MRI) studies, abnormalities of brain structure and resting-state connectivity were demonstrated in patients with long-term remission of CD. However, no data are available on functional alteratio...

ea0037gp.21.04 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Exaggerated and additive ACTH responses following the combined ghrelin+CRH test in patients with Cushing's disease

Miljic Dragana , Polovina Snezana , Doknic Mirjana , Pekic Sandra , Stojanovic Marko , Petakov Milan , Popovic Vera , Micic Dragan

Ghrelin is able to stimulate HPA axis in both humans and animals. Exaggerated ACTH and cortisol responses to ghrelin have been shown in patients with CD. Here we studied the role of ghrelin alone or in combination with CRH in the diagnosis of CD. In 21 CD patient (18 female, age 49.8±10.2 years, BMI 29.8±0.8 kg/m2, ten macroadenomas 11 microadenomas) we performed: i) ghrelin test (100 μg iv bolus) ii) CRH test (100 μg iv bolus) and iii) ghrelin+C...

ea0037gp.21.05 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Mental fatigue and executive dysfunction in patients with Cushing's syndrome in remission

Papakokkinou Eleni , Berglund Peter , Johansson Birgitta , Ragnarsson Oskar

Background: Patients with Cushing’s syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. Mental fatigue is characterized by mental exhaustion which appears especially during sensory stimulation or following mentally strenuous tasks. Other typical features are long recovery time for restoration of mental energy, irritability, impaired memory and concentration and sensitivity to stress, light and noise. The primary aim of this stu...

ea0037gp.21.06 | Pituitary – Diagnosis of Cushing's disease | ECE2015

Prolactine and urinary free cortisol measurement improve inferior petrosal sinus sampling results in ACTH dependent Cushing's Syndrome

Montanana Carmen Fajardo , Navarro Lucia Camarena , Puchol Ma Dolores Ferrer , Ortiz Carmen Valldecabres , Vela Jose Gomez , Suarez Pedro Riesgo

Introduction: Inferior petrosal sinus sampling (IPSS) is considered to be the gold standard for confirming the source of ACTH secretion in patients with Cushing’s syndrome (CS). Prolactin measurement during IPSS can improve diagnostic accuracy and reduces false negative responses.Patients and methods: 56 patients with ACTH-dependent CS were included (45 F/11 M, mean age 43.6±10.8 years and 90.1% Cushing’s disease) diagnosed since 2000. IPS...