CardioVascular and Interventional Radiology

, Volume 16, Issue 5, pp 287–292 | Cite as

Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: Effects of corticotropin-releasing factor and thyrotropin-releasing hormone on pituitary secretion

  • Thomas R. Strack
  • Hans H. Schild
  • Jurgen Bohl
  • Jurgen Beyer
  • Jurgen Schrezemeir
  • George Kahaly
Clinical Investigations


We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents—corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed production of both ACTH and prolactin in tumor cells, explaining the abnormal secretion pattern of the pituitary adenoma. The use of CRF and TRH may therefore improve the reliability of selective blood sampling and tests from the IPS in those cases of Cushing's disease for which noninvasive methods have otherwide failed to clarify the diagnosis.

Key words

Pituitary neoplasms Microadenoma Cushing's syndrome Angiography 


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Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Thomas R. Strack
    • 1
  • Hans H. Schild
    • 2
  • Jurgen Bohl
    • 3
  • Jurgen Beyer
    • 1
  • Jurgen Schrezemeir
    • 1
  • George Kahaly
    • 1
  1. 1.Department of Internal Medicine and EndocrinologyJohannes Gutenberg UniversityMainzFederal Republic of Germany
  2. 2.Department of RadiologyJohannes Gutenberg UniversityMainzFederal Republic of Germany
  3. 3.Department of NeuropathologyJohannes Gutenberg UniversityMainzFederal Republic of Germany

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