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Venous thrombo-embolism following inferior petrosal sinus sampling in Cushing’s disease

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Abstract

Bilateral inferior petrosal sinus sampling for ACTH with corticotrophin releasing hormone stimulation has become an established test in differentiating pituitary Cushing’s disease from Cu-shing’s syndrome due to ectopic ACTH secretion. We report two patients with Cushing’s disease who developed thromboembolic complications soon after inferior petrosal sinus sampling. We discuss the possible mechanisms leading to this complication in a syndrome in which thromboembolic complications are well recognized and highlight the need for consideration of prophylactic anticoagulation.

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References

  1. Oldfield E.H., Doppman J.L., Nieman L.K., Chrousos G.P., Miller D.L., Katz D.A., Cutler Jr. G.B., Loriaux L. Petrosal sinus sampling with and without corticotrophin releasing-hormone for the differential diagnosis of Cushing’s syndrome. N. Engl. J. Med., 1991, 325: 897–905.

    Article  CAS  PubMed  Google Scholar 

  2. Miller D.L., Doppman J.L. Petrosal sinus sampling: technique and rationale. Radiology 1991, 178: 37–47.

    CAS  PubMed  Google Scholar 

  3. Miller D.L., Doppman J.L., Peterman S.B., Nieman L.K., Oldfield E.H., Chang R. Neurologic complications of inferior petrosal sinus sampling. Radiology 1992, 185: 143–147.

    CAS  PubMed  Google Scholar 

  4. Seyer H., Honnegger J., Schott W., Kuchle M., Huk W.J., Fahlbusch R., Frisch H. Raymond’s syndrome following petrosal sinus sampling. Acta Neurochir. 1994, 131: 157–159.

    Article  CAS  PubMed  Google Scholar 

  5. Sturrock N.D., Jeffcoate W.J. A neurological complication of inferior petrosal sinus sampling in the investigation of Cushing’s disease. J. Neurol. Neurosurg. Psychiatry 1997, 527–528.

    Google Scholar 

  6. Diez J.J., Iglesias P. Pulmonary thromboembolism after Inferior petrosal sinus sampling in Cushing’s syndrome. Clin. Endocrinol. 1997, 46: 777.

    CAS  Google Scholar 

  7. Corrigan D.F., Schaff M., Whaley R.A., Czerwinski C.L., Earll J.M. Selective venous sampling to differentiate ectopic ACTH secretion from pituitary Cushing’s syndrome. N. Engl. J. Med. 1997, 296: 861–862.

    Article  Google Scholar 

  8. Gibson R.N., Hennessy O.F., Collier N., Hemingway H. Major complications of central venous catheterisation; a report of five cases and a brief review of the literature. Clin. Radiol. 1985, 36: 205–208.

    Article  CAS  PubMed  Google Scholar 

  9. Havill J.H. Central venous thrombosis following central venous catheterisation and parental nutrition, case report. N. Z. Med. J. 1975, 81: 420–422.

    CAS  PubMed  Google Scholar 

  10. Semple P.L., Laws E.R. Complications in a contemporary series of patients who underwent transsphenoidal surgery for Cushing’s disease. J. Neurosurg. 1999, 91: 175–179.

    Article  CAS  PubMed  Google Scholar 

  11. Small M., Lowe G.D.O., Forbes D., Thomson J.A. Thromboembolic complications in Cushing’s syndrome. Clin. Endocrinol. 1983, 19: 503–511.

    Article  CAS  Google Scholar 

  12. Patrassi G.M., Sartori M.T., Viero M.L., Scarano L., Boscaro M., Girolami A. The fibrinolytic potential in a patient with Cushing’s disease: A clue to the hypercoagulable state. Blood Coagul. Fibrinolysis 1992, 3: 789–792.

    Article  CAS  Google Scholar 

  13. Patrassi G.M., Dal Bo Zanon R., Boscaro M., Martinelli S., Girolami A. Further studies on the hypercoagulable state of patients with Cushing’s syndrome. Thromb. Haemost. 1985, 54: 518–520.

    CAS  PubMed  Google Scholar 

  14. Dal Bo Zanon R., Fornasiero L., Boscaro M., Cappellato G., Fabris F., Girolami A. Increased Factor VIII associated activities in Cushing’s syndrome: A possible hypercoagulable state. Thromb. Haemost. 1982, 47: 116–117.

    Google Scholar 

  15. Sjoberg H.E., Blomback M., Granberg P.O. Thromboembolic complications, heparin treatment and increase in coagulation factors in Cushing’s syndrome. Acta Med. Scand. 1976, 199: 95–98.

    Article  CAS  PubMed  Google Scholar 

  16. Kakkar V.V. Effectiveness and safety of low molecular weight Heparins in the prevention of venous thromboem-bolism. Thromb. Haemost. 1995, 74: 364–368.

    CAS  PubMed  Google Scholar 

  17. Kakkar V.V., Cohen A.T., Mohamed M.S. Patients at risk of venous thromboembolism, clinical results with Reviparin. Thromb. Res. 1996, 81 (Suppl. 2), S39–S45.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to J. S. Davies.

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Obuobie, K., Davies, J.S., Ogunko, A. et al. Venous thrombo-embolism following inferior petrosal sinus sampling in Cushing’s disease. J Endocrinol Invest 23, 542–544 (2000). https://doi.org/10.1007/BF03343772

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  • DOI: https://doi.org/10.1007/BF03343772

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