Skip to main content
SpringerLink
Log in

Assay Methods in Cushing’s Syndrome

  • Chapter
Cushing’s Syndrome

  • 145 Accesses

Abstract

The successful and accurate laboratory evaluation of Cushing’s syndrome is heavily dependent upon the availability of assays which are specific and sufficiently sensitive to detect the analytes of interest not only under normal physiologic conditions but also especially in situations where these analytes are suppressed either due to natural causes (e.g. suppression of pituitary ACTH by a functional adrenal adenoma) or to pharmacologic testing (e.g. dexamethasone suppression). Immunoassays (radioimmunoassay [RIA], enzyme-linked immunosorbent assay [ELISA], immunoradiometric assay [IRMA] etc) have several advantages over other methods, including relatively low cost, speed, large capacity, and usual ability to measure substances directly (with the notable exception of urinary steroids), thus avoiding extraction methods and the possible need to correct for variable recoveries,. The quality or characteristics of the primary antisera and the purity and specific activity of the tracer or other detection method contribute significantly to the sensitivity and specificity of such assays. HPLC is well adapted for small analytes such as steroids and has the potential of detecting synthetic as well as endogenously produced steroids. The finding of unusually low cortisol levels in a situation where elevated levels would be expected suggests exposure to synthetic steroids. Sample extraction is mandatory for all samples, including serum, plasma, saliva and urine.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lin C-L, Wu T-J, Machacek DA, Jiang N-S, Kao, PC. 1997 Urinary free cortisol and cortisone determined by high performance liquid chromatography in the diagnosis of Cushing’s syndrome.. J Clin Endocrinol Metab 82:151–155.

    Article  PubMed  CAS  Google Scholar 

  2. Quddusi S, Browne P, Toivola B, Hirsch IB. 1998 Cushing syndrome due to surreptitious glucocorticoid administration. Arch Intern Med. 158:294–296

    Article  PubMed  CAS  Google Scholar 

  3. Tsuruoka S, Sugimoto K, Fujimura A. 1998 Drug induced Cushing’s syndrome due to surreptitious glucocorticoid administration. Therapeutic Drug Monitoring. 20:387–389.

    Article  PubMed  CAS  Google Scholar 

  4. Turpeinen U, Markkanen H, Valimaki M, Stenman U-H. 1997 Determination of urinary free cortisol by HPLC. Clin Chem. 43:1386–1391.

    PubMed  CAS  Google Scholar 

  5. Findling JW, Pinkstaff SM, Shaker JL, Raff H, Nelson JC. 1988 Pseudohypercortisoluria: Spurious elevation of urinary cortisol due to carbamazepine. The Endocrinologist 8:51–54.

    Article  Google Scholar 

  6. Findlay CA, Macdonald JF, Wallace AM, Geddes N, Donaldson MDC. 1998 Childhood Cushing’s syndrome induced by betamethasone nose drops, and repeat prescriptions. Brit Med J. 317: 739–740.

    Article  PubMed  CAS  Google Scholar 

  7. Workman RJ, Nicholson WE, McCammon DK. 1995 Factitious hypercortisoluria. J Clin Endocrinol Metabol 80:3050–3051.

    Article  CAS  Google Scholar 

  8. Padmanabhan S, Rosenberg AS. 1998 Cushing’s syndrome induced by megestrol acetate in a patient with AIDS. Clin Infectious Dis. 27:217–218.

    Article  CAS  Google Scholar 

  9. Shotliff K, Nussey SS. 1997 Medroxyprogesterone acetate induced Cushing’s syndrome. Brit J Clin Pharmacol. 44:304.

    CAS  Google Scholar 

  10. Lee C, Goeger DE. 1998 Interference of 6β-hydroxycortisol in the quantitation of urinary free cortisol by immunoassay and its elimination by solid phase extraction. Clin Biochem 31:229–233.

    Article  PubMed  CAS  Google Scholar 

  11. Murphy BEP, Okouneff LM, Klein GP, Ngo SC. 1981 Lack of specificity of cortisol determinations in human urine. J Clin Endocrinol Metab. 53:91–99

    Article  PubMed  CAS  Google Scholar 

  12. Nahoul K, Patricot M-C, Moatti J-P, Revol A. 1992 Determination of urinary cortisol with three commercial immunoassays. J Steroid Biochem Molec Biol. 43:573–580.

    Article  PubMed  CAS  Google Scholar 

  13. Sapin R, Schlienger JL, Gasser F, Pradignac A, Grucker D. 1998 Improved specificity of a new direct assay for urinary cortisol: application in corticoid treated patients. Clin Chem Lab Med. 36:855–858.

    Article  PubMed  CAS  Google Scholar 

  14. Van Herle AJ, Birnbaum JA, Slomowitz LA, Mayes D, Chandler DW, Rosenblit PD, Nissenson A. 1998 Paper chromatography prior to cortisol RIA allows for accurate use of the dexamethasone suppression test in chronic renal failure. Nephron 80:79–84

    Article  PubMed  Google Scholar 

  15. Ulick S, Chan CK, Wang JZ. 1991 Measurement of 4 urinary C-18 oxygenated corticosteroids by stable isotope dilution mass fragmentography. J Steroid Biochem Molec Biol. 38:59–66..

    Article  PubMed  CAS  Google Scholar 

  16. Morineau G, Gosling J, Patricot M-C, Soliman J, Boudou P, Halnak AA, LeBrun G, Brerault J-L, Julien R, Villette J-M, Fiet J. 1997 Convenient chromatographic prepurification step before measurement of urinary cortisol by radioimmunoassay. Clin Chem 43:786–793.

    PubMed  CAS  Google Scholar 

  17. Workman RJ, Vaughn WK, Stone WJ. 1986 Dexamethasone suppression testing in chronic renal failure: pharmacokinetics of dexamethasone and demonstration of a normal hypothalamic-pituitary-adrenal axis. J. Clin. Endocrinol. Metabol. 63:741–746.

    Article  CAS  Google Scholar 

  18. Veldman RG, Meinders AE. 1996 On the mechanism of alcohol-induced pseudo-Cushing’s syndrome. Endo. Rev. 17:262–268

    Article  Google Scholar 

  19. Hirsch MS, Klibanski A. 1998 Editorial response: What price progress? Pseudo-Cushing’s syndrome associated with anti-retroviral therapy in patients with human immunodeficiency virus infection. Clin. Inf. Diseases 27:73–75.

    Article  CAS  Google Scholar 

  20. Meikle AW. 1982 Dexamethasone suppression tests: usefulness of simultaneous measurement of plasma cortisol and dexamethasone. Clin. Endocrinol. 16:401–408.

    Article  CAS  Google Scholar 

  21. Meikle AW, Lagerquist LG, Tyler FH. 1975 Apparently normal pituitary-adrenal suppressibility in Cushing’s syndrome: dexamethasone metabolism and plasma levels. J. Lab. Clin. Med. 86: 472–478.

    PubMed  CAS  Google Scholar 

  22. Meikle AW, Clarke DH, Tyler FH. 1976. Cushing’s syndrome resulting from a low dose of dexamethasone. JAMA 235:1592–1593

    Article  PubMed  CAS  Google Scholar 

  23. Tseui SE, Moore RG, Ashley JJ, McBride WG. 1979 Disposition of synthetic glucocorticoids. I. Pharmacokinetics of dexamethasone in healthy adults. J. Pharmacokinetics and Biopharmaceutics 7:249–264.

    Article  Google Scholar 

  24. Ashcraft MW, Van Herle AG, Vener SL, Geffner DL. 1982. Serum cortisol levels in Cushing’s syndrome after low-and high-dose dexamethasone suppression. Ann. Int. Med. 97:21–26.

    PubMed  CAS  Google Scholar 

  25. Arana GW, Reichlin S, Workman RJ, Hasser R, Shader RI. 1988 DST diagnostic utility for depression is enhanced by expressing serum cortisol as a function of serum dexamethasone (Dexamethasone Suppression Index, DSI). Amer J Psychiatry 14:707–711.

    Google Scholar 

  26. Arana GW, Workman RG, Baldessarini RJ. 1984. Association between low plasma levels of dexamethasone and elevated levels of cortisol in psychiatric patients given dexamethasone. Amer. J. Psychiatry. 141: 1619–1620.

    CAS  Google Scholar 

  27. Issa BG, Page MD, Read G, John R, Douglas-Jones A, Scanlon MF. 1999 Undetectable urinary free cortisol concentrations in a case of Cushing’s disease. Eur J Endocrinol 140:148–151.

    Article  PubMed  CAS  Google Scholar 

  28. Takahashi H, Teranishi Y, Nakanishi S, Numa S. 1981 Isolation and structural organization of the human corticotropin-β-lipotropin precursor gene. FEBS Lett 135:97–102.

    Article  PubMed  CAS  Google Scholar 

  29. Benjannet S, Rondeau N, Day R, Chrétien M, Seidah NG. 1991 PC1 and PC2 are proprotein convertases capable of cleaving proopiomelanocortin at distinct pairs of basic residues. Proc Nat Acad Sci USA 88:3564–3568.

    Article  PubMed  CAS  Google Scholar 

  30. Thomas L, Leduc R, Thorne BA, Smeekens SP, Steiner DF, Thomas G. 1991 Kex2-like endoproteases PC2 and PC3 accurately cleave a model prohormone in mammalian cells: Evidence for a common core of neuroendocrine processing enzymes. Proc Natl Acad Sci USA 88:5297–5301.

    Article  PubMed  CAS  Google Scholar 

  31. Ney RL, Ogata E, Shimizu N, Nicholson WE, Liddle GW. 1964 Structure-function relationships of ACTH and MSH analogues. Excerpta Medica International Congress Series No. 83:1184–1191.

    Google Scholar 

  32. Eipper BA, Mains RE. 1980 Structure and biosynthesis of proadrenocorticotropin/endorphin and related peptides. Endocr Rev 1:1–27.

    Article  PubMed  CAS  Google Scholar 

  33. Berson, SA, Yalow RS. 1968 Radioimmunoassay of ACTH in plasma. J Clin Invest 47:2725–2751.

    Article  PubMed  CAS  Google Scholar 

  34. Demura H, West CD, Nugent CA, Nakagawa K, Tyler FH. 1966 A sensitive radioimmunoassay for plasma ACTH levels. J Clin Endocrinol 26:1297–1302.

    Article  CAS  Google Scholar 

  35. Krieger DT, Liotta AS, Suda T, Goodgold A, Condon E. 1979 Human plasma immunoreactive lipotropin and adrenocorticotropin in normal subjects and in patients with pituitary-adrenal disease. J Clin Endocrinol Metab 48:566–571.

    Article  PubMed  CAS  Google Scholar 

  36. Landon J, Greenwood FC. 1968 Homologous radioimmunoassay for plasma-levels of corticotrophin in man. Lancet 1:273–276.

    Article  Google Scholar 

  37. Nicholson, WE, Davis DR, Sherrell BJ, Orth DN. Rapid radioimmunoassay for corticotropin in unextracted human plasma. Clin Chem 30:256–265.

    Google Scholar 

  38. Invitti C, Giraldi FP, de Martin M, Cavagnini F. 1999 Diagnosis and management of Cushing’s syndrome: results of an Italian multicentre study. J Clin Endocrinol Metabol. 84:440–448.

    Article  CAS  Google Scholar 

  39. Hodgkinson SC, Allolio B, Landon J, Lowry PJ. 1983 Development of a non-extracted ‘two-site’ immunoradiometric assay for corticotropin utilizing extreme amino-and carboxy-terminally directed antibodies. Biochem J 218:703–711.

    Google Scholar 

  40. Miles LEM, Hales CN. 1968 Labelled antibodies and immunological assay systems. Nature 219:186–189.

    Article  PubMed  CAS  Google Scholar 

  41. White A, Smith H, Hoadley M, Dobson SH, Ratcliffe JG. 1987 Clinical evaluation of a two-site immunoradiometric assay for adrenocorticotrophin in unextracted human plasma using monoclonal antibodies. Clin Endocrinol 26:41–52.

    Article  CAS  Google Scholar 

  42. Fukata J, Naitoh Y, Usui T, Nakaishi S, Nakai Y, Imura H. 1989 Two-site immunoradiometric assay for adrenocorticotrophin: A cautionary study about the reactivity to its precursor molecules. Endocrinol Jpn 36: 155–161.

    Article  PubMed  CAS  Google Scholar 

  43. Stewart PM, Gibson S, Crosby SR et al. 1994 ACTH precursors characterize the ectopic ACTH syndrome. Clin Endocrinol 40:199–204.

    Article  CAS  Google Scholar 

  44. Raff H, Findling JW, Wong J. 1989 Short loop adrenocorticotropin (ACTH) feedback after ACTH-(1-24) injection in man is an artifact of the immunoradiometric assay J Clin Endocrinol Metab 69:678–680.

    Article  PubMed  CAS  Google Scholar 

  45. Kertesz G, Bourcier B, Cailla H, Jean F. 1998 Immunoradiometric assay of succinylated corticotropin: An improved method for quantification of ACTH. Clin Chem 44:78–85.

    PubMed  CAS  Google Scholar 

  46. Raff H, Findling JW. 1989 A new immunoradiometric assay for corticotropin evaluated in normal subjects and patients with Cushing’s syndrome. Clin Chem 35:596–600.

    PubMed  CAS  Google Scholar 

  47. Rosano TG, Demers LM, Hillam R, Dybas MT, Leinung M. 1995 Clinical and analytical evaluation of an immunoradiometric assay for corticotropin. Clin Chem 41: 1022–1027.

    PubMed  CAS  Google Scholar 

  48. Van Rijn JLML, Van Landeghem BAJ, Haima P, Goldschmidt HMJ. 1996 Evaluation of ACTH immunoradiometric assays. Clin Biochem 29:93–95.

    Article  PubMed  Google Scholar 

  49. Zahradnik R, Brennan G, Hutchison JS, Odell WD. 1989 Immunoradiometric assay of corticotropin with use of avidin-biotin separation. Clin Chem 35:804–807.

    PubMed  CAS  Google Scholar 

  50. Ghigo E, Arvat E, Ramunni J, et al. 1997 Adrenocorticotropin-and cortisol-releasing effect of hexarelin, a synthetic growth hormone-releasing peptide, in normal subjects. J Clin Endocrinol Metabol. 82:2439–2444.

    Article  CAS  Google Scholar 

  51. Vale W, Spiess J, Rivier C, Rivier J. 1981 Characterization of 41-residue ovine hypothalamic peptide that stimulates secretion of corticotropin and β-endorphin. Science 213:1394–1397.

    Article  PubMed  CAS  Google Scholar 

  52. Vale W, Rivier C, Brown MR, et al. 1983 Chemical and biological characterization of corticotropin releasing factor. Recent Prog Horm Res 39:245–270.

    PubMed  CAS  Google Scholar 

  53. Orth, DN. 1992 Corticotropin-releasing hormone in humans. Endocr Rev 13:164–191.

    PubMed  CAS  Google Scholar 

  54. Shibahara S, Morimoto Y, Furutani Y, et al. 1983 Isolation and sequence analysis of the human corticotropin-releasing factor precursor gene. EMBO J 2:775–779.

    PubMed  CAS  Google Scholar 

  55. Auchus RJ, Mastorakos G, Friedman TC, Chrousos GP. 1994 Corticotropin-releasing hormone production by a small cell carcinoma in a patient with ACTH-dependent Cushing’s syndrome. J Endocrinol Invest 17:447–452.

    PubMed  CAS  Google Scholar 

  56. Young J, Deneux C, Grino M, Oliver C, Chanson P, Schaison G. 1997 Pitfall of petrosal sinus sampling in a Cushing’s syndrome secondary to ectopic adrenocorticotropin-corticotropin releasing hormone (ACTH-CRH) secretion. J Clin Endocrinol Metab 83:305–308.

    Article  Google Scholar 

  57. Orth DN, Mount CD. 1987 Specific high-affinity binding protein for human corticotropin-releasing hormone in normal human plasma. Biochem Biophys Res Commun 143:411–417.

    Article  PubMed  CAS  Google Scholar 

  58. Ellis MJ, Livesey JR, Donald RA. 1988 Circulating plasma corticotropin-releasing factor-like immunoreactivity. J Endocrinol 117:299–307.

    Article  PubMed  CAS  Google Scholar 

  59. Fjellestad-Paulsen A, Abrahamsson P-A, Bjartell A, et al. 1988 Carcinoma of the prostate with Cushing’s syndrome. Acta Endocrinol 119:506–516.

    PubMed  CAS  Google Scholar 

  60. Tourniaire J, Rebattu B, Conte-Devolx B, et al. 1988 Syndrome de Cushing secondaire à la production ectopique de CRF par un carcinome médullaire du corps thyroïde. Ann Endocrinol (Paris) 4:61–67.

    Google Scholar 

  61. Sasaki A, Liotta AS, Luckey MM, Margioris AN, Suda T, Krieger DT. 1984 Immunoreactive corticotropin-releasing factor is present in human maternal plasma during the third trimester of pregnancy. J Clin Endocrinol Metab 59:812–814.

    Article  PubMed  CAS  Google Scholar 

  62. Cunnah D, Jessop DS, Besser GM, Rees LH. 1987 Measurement of circulating corticotrophin-releasing factor in man. J Endocrinol 113:123–131.

    Article  PubMed  CAS  Google Scholar 

  63. Suda T, Tomori N, Yajima F, et al. 1985 Immunoreactive corticotropin-releasing factor in human plasma. J Clin Invest 76:2026–2029.

    Article  PubMed  CAS  Google Scholar 

  64. Sasaki A, Sato S, Murakami O, et al. 1987 Immunoreactive corticotropin-releasing hormone present in human plasma may be derived from both hypothalamic and extrahypothalamic sources. J Clin Endocrinol Metab 65:176–182.

    Article  PubMed  CAS  Google Scholar 

  65. Gerl H, Knappe G, Rohde W, Stahl F, Wolff H, Martin H. 1990 Cushing-Syndrom bei CRF-produzierendem mediastinalem Karzinoid. Dtsch Med Wochenschr 115:332–336.

    Article  PubMed  CAS  Google Scholar 

  66. Hashimoto K, Nishioka T, Numata Y, Ogasa T, Kageyama J, Suemaru S. 1993 Plasma levels of corticotropin-releasing hormone in hypothalamic-pituitary-adrenal disorders and chronic renal failure. Acta Endocrinol 128:503–507.

    PubMed  CAS  Google Scholar 

  67. Jessop DS, Cunnah D, Millar JGB, et al. 1987 A phaeochromocytoma presenting with Cushing’s syndrome associated with increased concentrations of circulating corticotropin-releasing factor. J Endocrinol 113:133–138.

    Article  PubMed  CAS  Google Scholar 

  68. Nawata H, Higuchi K, Ikuyama S, et al. 1990 Corticotropin-releasing hormone-and adrenocorticotropin-producing pituitary carcinoma with metastases to the liver and lung in a patient with Cushing’s disease. J Clin Endocrinol Metab 71:1068–1073.

    Article  PubMed  CAS  Google Scholar 

  69. O’Brien T, Young WF Jr, Davila DG, et al. 1992 Cushing’s syndrome associated with ectopic production of corticotrophin-releasing hormone, corticotrophin and vasopressin by a phaeochromocytoma. Clin Endocrinol 37:460–467.

    Article  Google Scholar 

  70. Puchner MJA, Lüdecke DK, Valdueza JM, et al. 1993 Cushing’s disease in a child caused by a corticotropin-releasing hormone-secreting intrasellar gangliocytoma associated with an adrenocorticotropic hormone-secreting pituitary adenoma. Neurosurgery 33:920–925.

    Article  PubMed  CAS  Google Scholar 

  71. Schteingart DE, Lloyd RV, Akil H, et al. 1986 Cushing’s syndrome secondary to ectopic corticotropin-releasing hormone-adrenocorticotropin secretion. J Clin Endocrinol Metab 63:770–775.

    Article  PubMed  CAS  Google Scholar 

  72. Yanovski JA, Nieman LK, Doppman JL, et al. 1998 Plasma levels of corticotropin-releasing hormone in the inferior petrosal sinuses of healthy volunteers, patients with Cushing’s syndrome, and patients with pseudo-Cushing states. J Clin Endocrinol Metab 83:1485–1488.

    Article  PubMed  CAS  Google Scholar 

  73. Linton EA, McLean C, Nieuwenhuyzen Kruseman AC, Tilders FJ, Van der Veen EA, Lowry, PJ. 1987 Direct measurement of human plasma corticotropin-releasing hormone by “two-site” immunoradiometric assay. J Clin Endocrinol Metab 64:1047–1053.

    Article  PubMed  CAS  Google Scholar 

  74. Behan DP, Khongsaly O, Liu X-J, et al. 1996 Measurement of corticotropin-releasing factor (CRF), CRF-binding protein (CRF-BP), and CRF/CRF-BP complex in human plasma by two-site enzyme-linked immunoabsorbant assay. J Clin Endocrinol Metab 81:2579–2586.

    Article  PubMed  CAS  Google Scholar 

  75. Liddle GW, Nicholson WE, Island DP, Orth DN, Abe K, Lowder SC. 1969 Clinical and laboratory studies of ectopic humoral syndromes. Recent Prog Horm Res 25:283–314.

    PubMed  CAS  Google Scholar 

  76. Aron DC, Raff H, Findling JW. 1997 Effectiveness versus efficacy: The limited value in clinical practice of high dose dexamethasone suppression testing in the differential diagnosis of adrenocorticotropin-dependent Cushing’s syndrome. J Clin Endocrinol Metab 82:1780–1785.

    Article  PubMed  CAS  Google Scholar 

  77. Yalow RS, Berson SA. 1971 Size heterogeneity of immunoreactive human ACTH in plasma and in extracts of pituitary glands and ACTH-producing thymoma. Biochem Biophys Res Commun 44:439–445.

    Article  PubMed  CAS  Google Scholar 

  78. Orth DN, Nicholson WE, Mitchell WM, Island DP, Liddle GW. 1973 Biologic and immunologic characterization and physical separation of ACTH and ACTH fragments in the ectopic ACTH syndrome. J Clin Invest 52:1756–1769.

    Article  PubMed  CAS  Google Scholar 

  79. Ratcliffe JG, Scott AP, Bennett HPJ, et al. 1973 Production of a corticotrophin-like intermediate lobe peptide and of corticotrophin by a bronchial carcinoid tumour. Clin Endocrinol 2:51–55.

    Article  CAS  Google Scholar 

  80. Ratter SJ, Gillies G, Hope J, et al. 1983 Pro-opiocortin related peptides in human pituitary and ectopic ACTH secreting tumours. Clin Endocrinol 18:211–218.

    Article  CAS  Google Scholar 

  81. Hale AC, Besser GM, Rees LH. 1986 Characterization of pro-opiomelanocortin-derived peptides in pituitary and ectopic adrenocorticotrophin-secreting tumours. J Endocrinol 108:49–56.

    Article  PubMed  CAS  Google Scholar 

  82. Bertagna X, Lenne F, Comar D, et al. 1986 Human β-melanocyte-stimulating hormone revisited. Proc Natl Acad Sci USA 83:9719–9723.

    Article  PubMed  CAS  Google Scholar 

  83. Vieau D, Massias J-F, Girard F, Luton J-P, Bertagna X. 1989 Corticotrophin-like intermediary lobe peptide as a marker of alternate pro-opiomelanocortin processing in ACTH-producing non-pituitary tumours. Clin Endocrinol 31:691–700.

    Article  CAS  Google Scholar 

  84. Raffin-Sanson M-L, Massias J-F, Dumont C, et al. 1996 High plasma proopiomelanocortin in aggressive adrenocorticotropin-secreting tumors. J Clin Endocrinol Metab 81:4272–4277.

    Article  PubMed  CAS  Google Scholar 

  85. White A, Gibson S. 1998 ACTH precursors: Biological significance and clinical relevance. Clin Endocrinol 48:251–255.

    Article  CAS  Google Scholar 

  86. Bertagna XY, Nicholson WE, Sorenson GD, Pettengill OS, Mount CD, Orth DN. 1978 Corticotropin, lipotropin, and β-endorphin production by a human nonpituitary tumor in culture: Evidence for a common precursor. Proc Natl Acad Sci USA 75:5160–5164.

    Article  PubMed  CAS  Google Scholar 

  87. Crosby SR, Stewart MF, Ratcliffe JG, White A. 1988 Direct measurement of the precursors of adrenocorticotropin in human plasma by two-site immunoradiometric assay. J Clin Endocrinol Metab 67:1272–1277.

    Article  PubMed  CAS  Google Scholar 

  88. Scopsi L, Gullo M, Rilke F, Martin S, Steiner DF. 1995 Proprotein convertases (PC1/PC3 and PC2) in normal and neoplastic human tissues: Their use as markers of neuroendocrine differentiation. J Clin Endocrinol Metab 80:294–301.

    Article  PubMed  CAS  Google Scholar 

  89. Creemers JWM, Roebroek AJM, Van de Ven WJM. 1992 Expression in human lung tumor cells of the proprotein processing enzyme PC1/PC3. FEBS Lett 300:82–88.

    Article  PubMed  CAS  Google Scholar 

  90. Crosby SR, Stewart MF, Farrell WE, Gibson S, White A. 1990 Comparison of ACTH and ACTH precursor peptides secreted by human pituitary and lung tumour cells in vitro. J Endocrinol 125:147–152.

    Article  PubMed  CAS  Google Scholar 

  91. Deftos LJ. 1991 Chromogranin A: Its role in endocrine function and as an endocrine and neuroendocrine tumor marker. Endocr Rev 12:181–187.

    Article  PubMed  CAS  Google Scholar 

  92. Nobels FRE, de Herder WW, Kwekkeboom DJ, et al. 1994 Serum chromogranin A in the differential diagnosis of Cushing’ s syndrome. Eur J Endocrinol 131:589–593.

    Article  PubMed  CAS  Google Scholar 

  93. De Bold, AJ. 1986 Atrial natriuretic factor: An overview. Fed Proc 45:2081–2085.

    PubMed  Google Scholar 

  94. Opocher G, Rocco S, Carpenè G, et al. 1990 Atrial natriuretic peptide in Cushing’s disease. J Endocrinol Invest 13:133–137.

    PubMed  CAS  Google Scholar 

  95. Colao A, Pivonello R, Ferone D, et al. 1998 Effect of corticotrophin-releasing hormone on arginine vasopressin and atrial natriuretic factor in patients with Cushing’s disease. Clin Endocrinol 49:77–84.

    Article  CAS  Google Scholar 

  96. Okada S, Ohshima K, Mori M. 1994 The Cushing syndrome induced by atrial natriuretic peptide-producing thymic carcinoid. Ann Intern Med 121:75–76.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Vanderbilt School of Medicine, Nashville, TN, USA

    Wendell Nicholson BS & Robert J. Workman MD

Authors
  1. Wendell Nicholson BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert J. Workman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The Pituitary Center at Vanderbilt, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Lewis S. Blevins Jr. M.D. (Associate Professor of Medicine & Neurological Surgery) (Associate Professor of Medicine & Neurological Surgery)

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Nicholson, W., Workman, R.J. (2002). Assay Methods in Cushing’s Syndrome. In: Blevins, L.S. (eds) Cushing’s Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1103-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-1103-8_6

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5396-6

  • Online ISBN: 978-1-4615-1103-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation