Evidence map›Paper›PMID 32451985›Full record

ArticlePituitary2020

High accuracy of bilateral and simultaneous petrosal sinus sampling with desmopressin for the differential diagnosis of pediatric ACTH-dependent Cushing's syndrome.

Lara Bessa Campelo Pinheiro Cavalcante, Thais Castanheira Freitas, Nina Rosa Castro Musolino, Valter Angelo Sperling Cescato, Gilberto Ochman Silva, Maria Candida Barisson Villares Fragoso, Paulo Puglia, Marcello Delano Bronstein, Marcio Carlos Machado

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In one paragraph

Article in Pituitary, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Lara Bessa Campelo Pinheiro CavalcanteNeuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Thais Castanheira FreitasNeuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Nina Rosa Castro MusolinoNeurosurgery Service, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Valter Angelo Sperling CescatoNeurosurgery Service, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Gilberto Ochman SilvaNeurosurgery Service, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Maria Candida Barisson Villares FragosoAdrenal Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Paulo PugliaNeuroradiology Service, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Marcello Delano BronsteinNeuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Marcio Carlos MachadoNeuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil. marcioc-machado@uol.com.br.ORCID http://orcid.org/0000-0002-1673-3749
Universidade de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo analyze the bilateral and simultaneous petrosal sinus sampling (BIPSS) in a subgroup of children and adolescents with ACTH-dependent Cushing's syndrome (ADCS)

methodsRetrospective study in a tertiary reference center. From 1993 and 2017, 19 children and adolescents (PED) were submitted to the BIPSS, median age of 14 years (range 9-19 years), 53% were males, 18 had Cushing's disease (CD) and one had ectopic ACTH syndrome (EAS). All procedures were performed with 10 µg of intravenous desmopressin.

resultsThe catheter positioning was successful in all cases. The central ACTH gradient was met in 17/19 cases. At baseline, central gradient occurred in 16/19 (84%) with gradient values of 7.2 ± 6.0. After stimulation, there was an increase in the center-periphery gradient values (33.6 ± 44.3). In one case, central gradient was defined only after stimulation. Two cases presented without a central gradient; one case of CD with a false-negative and one EAS case. Lateralization occurred in all cases with a central gradient. Confirmation of the tumor location presumed by the procedure with the surgical description occurred in 60% of the cases. The BIPSS in this PED subgroup of ADCS presented a sensitivity of 94.4% and specificity of 100%. There were no complications of the procedure.

conclusionIn a series of children and adolescents with ADCS, BIPSS was safe and highly accurate in defining the central to peripheral ACTH gradient using desmopressin as secretagogue. Nevertheless, there was a limited value of the ACTH-gradient between the petrosal sinuses for the tumor location.

Indexed as

AdolescentAdultChildCushing SyndromeDeamino Arginine VasopressinFemaleHumansMalePetrosal Sinus SamplingPituitary ACTH HypersecretionRetrospective StudiesYoung AdultDeamino Arginine VasopressinBilateral and simultaneous petrosal sinus samplingCushing’s diseaseCushing’s syndromePediatric

Identifiers

PMID32451985
OpenAlexW3030861035

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.