OBJECTIVE: The demonstration of a central to peripheral ACTH gradient in a hypercortisolaemic @entity1 is diagnostic of @entity699 . We tried to determine whether single blood samples for ACTH obtained sequentially from each of the inferior petrosal sinuses following @entity1 corticotrophin-releasing hormone ( @entity6192 ) stimulation can reliably establish such a gradient. DESIGN: Prospective study. @entity1 : Seventeen @entity1 with clinical and biochemical features of @entity699 . METHODS: After the administration of @entity6192 , the @entity1 underwent bilateral sequential inferior petrosal sinus sampling, with a single blood sample obtained from each of the inferior petrosal sinuses sequentially, along with a peripheral venous sample. The petrosal sinus catheter was withdrawn immediately after obtaining a blood sample. @entity1 did not require indwelling catheters in the petrosal sinuses, nor heparinisation. RESULTS: Bilateral sequential inferior petrosal sinus sampling correctly identified a pituitary source of ACTH, as shown by a central to peripheral ACTH ratio >2, in all @entity1 in whom the procedure was successfully carried out. All @entity1 underwent transsphenoidal pituitary surgery resulting in remission. CONCLUSIONS: The simplified method of inferior petrosal sinus sampling, using a single sequential sample from each of the inferior petrosal sinuses, following initial @entity6192 stimulation, is as accurate as the more complex test using multiple bilateral simultaneous inferior petrosal sinus samples. It avoids the use of indwelling cerebral venous catheters and is therefore unlikely to cause brain stem damage.

Bilateral sequential inferior petrosal sinus sampling with corticotrophin-releasing hormone stimulation in the diagnosis of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'human', 'patients', 'patient', 'PATIENTS'] @entity6192 :: ('1392', 'Gene') :: ['hCRH'] @entity699 :: ('MESH:D003480', 'Disease') :: ["Cushing's disease", "Cushing's syndrome"]
@entity699 :: (MESH:D003480,Disease) :: ['Cushing's disease']
