Table 2.
Hormonal parameters.
Case number | PC (µg/dL) | ACTH (pg/mL) | LNSC (µg/dL) | UFC (µg/24 h) | 1-mg DST (µg/dL) | 8-mg DST ΔPCa % | CRH stimulation testb | BIPSS (ACTH C/P gradient)c | BIPSS (PRL C/P basal gradient) | Other hormones and biomarkers | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ΔACTH, % | ΔPC, % | Basal | After CRH | 17OH, µg/L | ADS, µg/dL | 5HIIA, mg/24h | CgA, ng/mL | ||||||||
Normal range | 5–25 | 5-60 | 0.0–0.2 | 20–120 | PC < 1.8 | 0.25–3.90 | 0.30–2.60 | 7–8.2 | 19–98 | ||||||
1 | 40.5 | 263 | - | 4470 | 37.2 | - | +43.91 | +14.04 | 1.78 | 0.97 | 29.5/12.8 = 2.30 | 8.26 | >10 | 82.7 | |
2 | 20 | 132.6 | 0.296 | 1229 | - | −1 | +45.02 | +8.83 | 1.39 | 1.73 | 11.8/10.8 = 1.09 | 5.86 | 9.6 | ||
3 | 49 | 75 | 1.21 | 838 | - | - | +19.41 | +11.5 | 1.39 | 1.56 | 5.5/8.1 = 0.67 | 5.26 | 293 | ||
4 | 27.8 | 139.5 | 0.063 | 2227 | 28.4 | +0.6 | +10 | +18.5 | 1.02 | 1.42 | - | >10 | |||
5 | 52.1 | 226 | - | 6246 | - | - | −20 | - | - | - | |||||
6 | 79.6 | 271.6 | - | 1500 | 86.1 | - | - | - | - | 3302 | |||||
7 | 98.1 | 248.2 | - | 1860 | 34.4 | −18.89 | - | - | - | >10 | ↑ | ||||
8 | 47.1 | 162.9 | - | 11,876 | 54.3 | - | - | - | - | 89 | |||||
9 | 42.4 | 274.8 | 1.12 | 1395 | 43.3 | −36.55 | - | - | - | 186 | |||||
10 | 62.8 | 120.1 | 0.05 | 2552 | 27.5 | - | - | - | - | - | |||||
11 | 49.9 | 84.6 | 2.12 | - | 45.7 | −8.61 | - | - | - | - | |||||
12 | 97.1 | 236.7 | - | 1920 | 79.4 | −13.18 | - | - | - | - |
aSuppression was considered if ΔPC < −50%; bStimulationwas positive for Cushing’s disease if ΔACTH > 50% and ΔPC >20%; cACTH C/P gradient basal >2 or after stimulation by CRH >3 was positive for Cushing’s disease.
1-mg DST, 1-mg (low-dose) dexamethasone suppression test; 5HIIA, 5 hydroxyindolacetic acid; 8-mg DST, 8-mg (high-dose) dexamethasone suppression test; 17OHP, 17 hydroxyprogesterone; ACTH, adrenocorticotropic hormone; BIPSS, bilateral inferior petrosal sinus sampling; C/P, central/peripheral; CgA, chromogranin A; CRH, corticotropin-releasing hormone; LNSC, late-night salivary cortisol; PC, plasma cortisol; PRL, prolactin; UFC, 24-h urinary free cortisol.