Evidence map›Paper›PMID 34655038›Full record

ArticleJournal of endocrinological investigation2022

Utility of bilateral inferior petrosal sinus sampling for diagnosis and lateralization of Cushing's disease in the pediatric population: case series and review of the literature.

K M Kang, K Muralidharan, H Knowlton, K I A Hassan, A Yekula, M Misra, B Swearingen, P S Jones

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Article in Journal of endocrinological investigation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

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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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Review
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

8 authors at 2 institutions in 1 country.

K M KangDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA. keikokan@usc.edu.
K MuralidharanDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
H KnowltonDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
K I A HassanDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
A YekulaDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
M MisraDivision of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
B SwearingenDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
P S JonesDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Massachusetts General Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectsCushing's disease (CD) is the most common cause of ACTH-dependent hypercortisolism in children age ≥ 7. The utility of bilateral inferior petrosal sinus sampling (BIPSS), an important test in adults, is less defined in children. We present a case series of children with ACTH-dependent hypercortisolemia and review the literature to assess the utility of BIPSS in the diagnosis and localization of CD.

methodsWe performed an IRB-approved chart review of patients aged ≤ 18 with ACTH-dependent hypercortisolism at MGH between 2000 and 2019 and collected clinical, laboratory, radiographic, BIPSS, surgical, and outcomes data.

resultsIn our cohort (n = 21), BIPSS had a sensitivity of 93% and specificity of 100% for diagnosis of CD. Compared to surgery, successful BIPSS correctly predicted adenoma laterality in 69% of cases vs. 70% by MRI. Among patients with lesions ≥ 4 mm (n = 9), BIPSS correctly lateralized in 50% vs. 100% by MRI. In patients with subtle lesions (< 4 mm, n = 7), BIPSS correctly lateralized in 80% vs. 71% by MRI. In patients (n = 4) with CD and negative MRIs, BIPSS correctly lateralized in 75% cases. Surgical cure was achieved in 90% of patients and 95% of patients had long-term disease control.

conclusionsIn our cohort (n = 21; n = 20 CD, n = 1 ectopic ACTH secretion), BIPSS was sensitive and specific for the diagnosis of CD. Compared to MRI, BIPSS was not additionally helpful for lateralization in patients with lesions ≥ 4 mm on MRI. BIPSS was helpful in guiding surgical exploration and achieving immediate postoperative remission among patients with subtle and negative MRI findings.

Indexed as

Pituitary ACTH HypersecretionPituitary NeoplasmsAdolescentAdrenocorticotropic HormoneBody Mass IndexFemaleHumansHydrocortisoneHypophysectomyMagnetic Resonance ImagingMalePetrosal Sinus SamplingRemission InductionReproducibility of ResultsTimeTreatment OutcomeAdrenocorticotropic HormoneHydrocortisoneBilateral inferior petrosal sinus samplingCushing’s diseaseLateralization of Cushing’s diseasePediatric

Identifiers

PMID34655038
OpenAlexW3205944608

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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.