False-Negative Inferior Petrosal Sinus Sampling in Young-Onset Cushing Disease: What Happens Next
Authors' conclusion
In patients with CD, IPSS may rarely lead to false-negative results. Management of these patients usually includes screening for ectopic sources of ACTH/CRH secretion, repeating IPSS if ectopic workup is negative, and considering medical management until final diagnosis of the source of hypercortisolism is made.
Study context
- Population
- Patients with young-onset (<21 years old) CD who underwent inferior petrosal sinus sampling (IPSS) during diagnostic evaluation; CD confirmed by histology of resected pituitary tumor or remission after transsphenoidal surgery142 IPSS procedures
- Outcome
- False-negative IPSS results
Main finding
As reported in the abstract
False-negative IPSS results (of 142 IPSS procedures)
5
3.5%
Unique patients with false-negative IPSS
4
Observational data: associations, not effects.
Further findings
Management of patients with false-negative IPSS
- Additional workup (ectopic Cushing syndrome (CS) evaluation, repeat IPSS)
- 3 of 4 patients
- Medical treatment for cortisol suppression
- 2 patients
- Pituitary exploration without additional evaluation
- 1 patient
- All patients finally underwent surgery and achieved remission
Original publication
False-Negative Inferior Petrosal Sinus Sampling in Young-Onset Cushing Disease: What Happens Next. Horm Res Paediatr. Published 14 December 2023. doi:10.
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