| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
University of Nijmegen Nijmegen, The Netherlands
Department of Medicine, Division of Endocrinology, and Department of Experimental and Chemical Endocrinology Nijmegen, The Netherlands
Address all correspondence and requests for reprints to: Ad R. M. M. Hermus, M.D., Department of Medicine, Division of Endocrinology, St. Radboud Hospital, University of Nijmegen, Nijmegen 6500 HB, The Netherlands.
The ACTH and cortisol responses to 100 µg ovine corticotropin-releasing hormone (CRH) in 19 consecutive patients with Cushing's disease were compared with those in 13 normal subjects. In 2 patients with Cushing's disease, plasma ACTH and cortisol did not increase after CRH administration. Compared to the normal subjects, maximal ACTH increments [135 ± 25 (±SEM) VS. 42 ± 6 pg/ml; P < 0.001, by Wilcoxon's two-sample test] and maximal cortisol increments (17.7 ± 1.8 vs. 9.4 ± 1.1 µg/100 ml; P < 0.01 by Wilcoxon's test) after CRH were significantly higher in the 17 CRH-responsive patients with Cushing's disease. In the normal subjects, there was a significant negative correlation between the basal cortisol level and the maximal ACTH (r = –0.65; P < 0.05, by Spearman's rank correlation test) and cortisol (r = –0.95; P < 0.001, by Spearman's test) responses to CRH. In contrast, in the CRHresponsive Cushing patients, there was no significant correlation between the basal cortisol level and the maximal ACTH (r = 0.10; P > 0.10, by Spearman's test) and cortisol (r = 0.14; P > 0.10, by Spearman's test) increments after CRH treatment. In the normal subjects, there was no significant correlation between the basal ACTH level and the maximal ACTH increments after CRH administration (r = –0.24; P > 0.10, by Spearman's test). Again in contrast, in the CRH-responsive Cushing patients, maximal ACTH increments after CRH treatment correlated positively with basal ACTH levels (r = 0.69; P < 0.005, by Spearman's test). Moreover, in these patients, the maximal ACTH increments after CRH were positively correlated with the ACTH levels after suppression with higher and lower doses of dexamethasone. We conclude that in Cushing's disease, unlike in normal subjects, circulating cortisol is not the major modulator of ACTH and cortisol responses to CRH, and that in these patients, responsivity of ACTH to CRH and lack of suppressibility by dexamethasone are related phenomena.
* Presented in part at the 67th Annual Meeting of The Endocrine Society, Baltimore, MD, June 19–21,1985 (Abstract 1004).
Received July 11, 1985.
This article has been cited by other articles:
![]() |
G. Arnaldi, G. Tirabassi, R. Papa, G. Furlani, L. Trementino, M. Cardinaletti, E. Faloia, and M. Boscaro Human corticotropin releasing hormone test performance in the differential diagnosis between Cushing's disease and pseudo-Cushing state is enhanced by combined ACTH and cortisol analysis Eur. J. Endocrinol., June 1, 2009; 160(6): 891 - 898. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M. Isidori, G. A. Kaltsas, S. Mohammed, D. G. Morris, P. Jenkins, S. L. Chew, J. P. Monson, G. M. Besser, and A. B. Grossman Discriminatory Value of the Low-Dose Dexamethasone Suppression Test in Establishing the Diagnosis and Differential Diagnosis of Cushing's Syndrome J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5299 - 5306. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Newell-Price, D. G. Morris, W. M. Drake, M. Korbonits, J. P. Monson, G. M. Besser, and A. B. Grossman Optimal Response Criteria for the Human CRH Test in the Differential Diagnosis of ACTH-Dependent Cushing's Syndrome J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1640 - 1645. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Newell-Price, P. Trainer, M. Besser, and A. Grossman The Diagnosis and Differential Diagnosis of Cushing's Syndrome and Pseudo-Cushing's States Endocr. Rev., October 1, 1998; 19(5): 647 - 672. [Abstract] [Full Text] |
||||
![]() |
K. D. Dieterich, E. D. Gundelfinger, D. K. Lüdecke, and H. Lehnert Mutation and Expression Analysis of Corticotropin-Releasing Factor 1 Receptor in Adrenocorticotropin-Secreting Pituitary Adenomas J. Clin. Endocrinol. Metab., September 1, 1998; 83(9): 3327 - 3331. [Abstract] [Full Text] |
||||
![]() |
D. N. Orth Cushing's Syndrome N. Engl. J. Med., March 23, 1995; 332(12): 791 - 803. [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |