Copeptin Levels Before and After Transsphenoidal Surgery for Cushing Disease: A Potential Marker of Remission
نویسندگان
چکیده
Abstract Objectives: Chronic hypercortisolemia suppresses AVP secretion. Copeptin makes up the C-terminal portion of precursor pre-pro-AVP, is released in stoichiometric amounts with AVP, and a stable surrogate marker AVP.A post-operative increase plasma copeptin was hypothesized to be remission Cushing Disease (CD). Methods: Plasma obtained patients CD before daily first week after transsphenoidal surgery (TSS), measured using Brahm Kryptor Compact PLUS sandwich immunofluorescent assay. Urine output, serum sodium, urine specific gravity, urine/serum osmolality were used determine development central diabetes insipidus (DI) and/or syndrome inappropriate anti-diuretic hormone secretion (SIADH). Change reflects pre-TSS peak post-TSS levels. Statistical analyses completed non-parametric tests. Results are presented as median (inter-quartile range). Results: Forty-four (64% female, 7-55 years old) included. After TSS, 8 (18%) developed DI, 13 (30%) SIADH, 4 (9%) both DI 19 (43%) neither. Thirty-three had follow-up at 3-6 months. Overall, there no difference for versus those not [6.1 pmol/L (4.3-12.1) vs. 7.3 (5.4-8.4), p=0.88]. There was, also, change [2.3 (-0.5-8.2) 0.1 (-0.1-2.2), p=0.46]. When we excluded who water balance disorder postoperatively, [10.2 (6.9-21.0)] [5.4 (4.6-7.3), p=0.032], but [5.1 (0.3-19.5) 1.1 p=0.39]. Conclusions: Post-TSS may useful early predict TSS. However, utility this test limited do develop disorders post-operatively. Additional studies larger sample sizes needed confirm these findings cutoff level that CD.
منابع مشابه
Comparing Quality of Life Before and After Surgery in Patients with Cushing Disease: A Before-After Study
متن کامل
Delayed remission after transsphenoidal surgery in patients with Cushing's disease.
BACKGROUND Transsphenoidal surgery (TSS) is the treatment of choice for Cushing's disease (CD). Postoperative hypercortisolemia mandates further therapy. OBJECTIVE The aim of the study was to characterize patients without immediate postoperative remission who have a delayed decrease to normal or low cortisol levels without further therapy. DESIGN AND SETTING A retrospective case series was ...
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متن کاملLong-term follow-up on Cushing disease patient after transsphenoidal surgery
Cushing disease is caused by excessive adrenocorticotropic hormone (ACTH) production by the pituitary adenoma. Transsphenoidal surgery is its first-line treatment. The incidence of Cushing disease in children and adolescents is so rare that long-term prognoses have yet to be made in most cases. We followed-up on a 16-year-old male Cushing disease patient who presented with rapid weight gain and...
متن کامل[Changes of specific and non-specific immunological functions before and after transsphenoidal tumor excision--a case of Cushing disease].
The interrelationship between the hypothalamic-pituitary-adrenal axis and the immune system has been becoming clear. However, most research about this interrelationship has been performed by in vitro experiments and by using animal models. To know the effect of hypercortisolism on human immune systems in vivo, we report at 32-year-old man with typical Cushing disease whose specific and non-spec...
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ژورنال
عنوان ژورنال: Journal of the Endocrine Society
سال: 2021
ISSN: ['2472-1972']
DOI: https://doi.org/10.1210/jendso/bvab048.1274