ArticleJournal of the Endocrine Society2019
Assay-Specific Spurious ACTH Results Lead to Misdiagnosis, Unnecessary Testing, and Surgical Misadventure-A Case Series.
Article in Journal of the Endocrine Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Corticotroph tumor progression after bilateral adrenalectomy (Nelson's syndrome): systematic review and expert consensus recommendations.European journal of endocrinology · 2021Pooled it
- Validated LC-MS/MS Methods for Quantification of AC02 and Porcine ACTHPharmaceuticals (Basel, Switzerland) · 2026Article
- Averting Potential Misinterpretations and Diagnostic Misapplications of Misleading Laboratory Results.Diagnostics (Basel, Switzerland) · 2026Review
- 11-deoxycortisol, other hormones and pituitary function characteristics in the diagnosis of adrenal insufficiency in the overnight oral metyrapone test.Endocrine connections · 2026Article
- Atypical Presentation and Course of ACTH-Independent Cushing’s Syndrome in Two FamiliesJournal of clinical research in pediatric endocrinology · 2026Article
- Multicenter 30-Year Data on the 4-Mg Intravenous Dexamethasone Suppression Test in the Diagnosis of Cushing Syndrome.Journal of the Endocrine Society · 2026Article
- Spurious Plasma Adrenocorticotropic Hormone Level in a Patient With Adrenal Cushing Syndrome.Ochsner journal · 2026Article
- Large-scale comparison of two immunoassays for adrenocorticotropic hormone in human plasma.Scientific reports · 2025Article
- Utility of gel filtration chromatography in evaluating successful resection of ectopic adrenocorticotropic hormone-producing tumor: a case report and literature review.Endocrine journal · 2025Review
- Pitfalls in the lab assessment of hypopituitarism.Reviews in endocrine & metabolic disorders · 2024Review
- Adrenal Incidentaloma-Innocent Bystander or Intruder?The Journal of clinical endocrinology and metabolism · 2024Article
- Detecting the interferences in adrenocorticotropic hormone measurement - three cases reinforcing the efficiency of the complementary clinical and laboratory audit.Biochemia medica · 2024Article
- Immunoassay interferences: laboratory pitfall in the diagnosis of adrenocortical carcinoma.BMJ case reports · 2024Article
- Recognition of Nonneoplastic Hypercortisolism in the Evaluation of Patients With Cushing Syndrome.Journal of the Endocrine Society · 2023Article
- Alcohol-induced Cushing syndrome: report of eight cases and review of the literature.Frontiers in endocrinology · 2023Review
- Distinct serum steroid profiles between adrenal Cushing syndrome and Cushing disease.Frontiers in endocrinology · 2023Article
- Molecular Derangements and the Diagnosis of ACTH-Dependent Cushing's Syndrome.Endocrine reviews · 2022Review
- Does concomitant prolactin measurement ıncrease the accuracy of ınferior petrosal sinus sampling?Neuroradiology · 2022Review
- Clinical Study and Systematic Review of Pituitary Microadenomas vs. Macroadenomas in Cushing's Disease: Does Size Matter?Journal of clinical medicine · 2022Article
- Outcome of CRH stimulation test and overnight 8 mg dexamethasone suppression test in 469 patients with ACTH-dependent Cushing's syndrome.Frontiers in endocrinology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
The proper clinical evaluation of pituitary and adrenal disorders depends on the accurate measurement of plasma ACTH. The modern two-site sandwich ACTH immunoassay is a great improvement compared with older methods but still has the potential for interferences such as heterophile antibodies and pro-opiomelanocortin (POMC) and ACTH fragments. We report the cases of five patients in whom the diagnosis or differential diagnosis of Cushing syndrome was confounded by erroneously elevated results from the Siemens ACTH Immulite assay [ACTH(Immulite)] that were resolved using the Roche Cobas or Tosoh AIA [ACTH(Cobas) and ACTH(AIA), respectively]. In one case, falsely elevated ACTH(Immulite) results owing to interfering antibodies resulted in several invasive differential diagnostic procedures (including inferior petrosal sinus sampling), MRI, and unnecessary pituitary surgery. ACTH(Cobas) measurements were normal, and further studies excluded the diagnosis of Cushing syndrome. In three cases, either Cushing disease or occult ectopic ACTH were suspected owing to elevated ACTH(Immulite) results. However, adrenal (ACTH-independent) Cushing syndrome was established using ACTH(AIA) or ACTH(Cobas) and proved surgically. In one case, ectopic ACTH was suspected owing to elevated ACTH(Immulite) results; however, the ACTH(Cobas) findings led to the diagnosis of alcohol-induced hypercortisolism that resolved with abstinence. We have concluded that ACTH(Immulite) results can be falsely increased and alternate ACTH assays should be used in the diagnosis or differential diagnosis of clinical disorders of the hypothalamic-pituitary-adrenal axis.
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Registered trials
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