Evidence map›Paper›PMID 41422341›Full record

ArticlePituitary2025

Diagnostic performance of desmopressin stimulation test in pediatric cushing's disease.

Yetunde B Omotosho, Richard Chang, Michael Kassin, Erna Groat, Alan Quillian, Ruth Parker, Christina Tatsi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pituitary, 2025. 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
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Yetunde B OmotoshoUnit on Hypothalamic and Pituitary Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Building 10, Rom 1-3330, MSC1103, Bethesda, MD, 20892, USA.
Richard ChangEndocrine and Venous Services Section, Interventional Radiology Section, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
Michael KassinEndocrine and Venous Services Section, Interventional Radiology Section, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
Erna GroatDepartment of Pharmacy, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
Alan QuillianDepartment of Pediatrics, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
Ruth ParkerDepartment of Pediatrics, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
Christina TatsiUnit on Hypothalamic and Pituitary Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Building 10, Rom 1-3330, MSC1103, Bethesda, MD, 20892, USA. christina.tatsi3@nih.gov.ORCID http://orcid.org/0000-0002-2882-4584

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the diagnostic performance of the desmopressin (DDAVP) stimulation test in pediatric patients with Cushing’s disease (CD), and to compare its accuracy and safety profile to the ovine corticotropin-releasing hormone (oCRH) stimulation test.

designA retrospective cohort study.

methodsPediatric patients with CD who underwent peripheral or bilateral inferior petrosal sinus sampling (BIPSS) stimulation testing with either DDAVP or oCRH were included. Patients were matched 1:1 for age, sex, and tumor size. The performance of each test was assessed by evaluating ACTH and cortisol responses and calculating test sensitivities.

resultsIn peripheral stimulation testing, DDAVP demonstrated 96.9% sensitivity for cortisol and 81.3% for ACTH, while oCRH showed 93.8% and 96.9% sensitivities respectively (p > 0.05). Percentage change of ACTH was higher in the CRH group compared to DDAVP. In BIPSS, the DDAVP stimulation showed sensitivity 73.3% for baseline and 80% for post-stimulation results, while oCRH had sensitivity 93.3% and 100% respectively. Central-to-peripheral ACTH ratios were similar across groups. No major adverse events were reported, and both tests were well tolerated.

conclusionAlthough the DDAVP stimulation test demonstrates lower diagnostic accuracy compared to the CRH test, it still provides sufficient sensitivity and given its availability and lower cost, it represents a pragmatic alternative to CRH stimulation. SIGNIFICANCE STATEMENT: The diagnosis of pediatric CD is challenging due to the rarity of the condition and limited access to dynamic testing agents such as ovine corticotropin-releasing hormone (oCRH). This study provides the largest pediatric evaluation of the desmopressin (DDAVP) stimulation test, demonstrating its diagnostic accuracy and safety profile comparable to oCRH stimulation. The findings support the use of DDAVP as a reliable and practical alternative for diagnosing CD in children, particularly in settings where oCRH is unavailable. This work addresses a critical gap in pediatric endocrinology and has the potential to improve diagnostic pathways and outcomes in this population.

Indexed as

Deamino Arginine VasopressinPituitary ACTH HypersecretionAdolescentAdrenocorticotropic HormoneAnimalsChildCorticotropin-Releasing HormoneFemaleHumansHydrocortisoneMalePetrosal Sinus SamplingRetrospective StudiesAdrenocorticotropic HormoneCorticotropin-Releasing HormoneDeamino Arginine VasopressinHydrocortisoneCRH testCushing’s diseaseDDAVPDesmopressin testDynamic tests

Identifiers

PMID41422341
PMCPMC12718224

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LicenceCC BY
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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.