Naris Nilubol1,1, Steven J Soldin2,3,2,3, Dhaval Patel1,1, Muthoni Rwenji2,2, Jianghong Gu2,2, Likhona S Masika2,2, Richard Chang4,4, Constantine A Stratakis5,5, Electron Kebebew1,1. 1. Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, MD 20892, USA. 2. Department of Laboratory Medicine, National Institutes of Health, MD 20892, USA. 3. Department of Medicine, Division of Endocrinology & Metabolism, Georgetown University, WA 20007, USA. 4. Endocrine & Venous Services Section, Interventional Radiology Section, Radiology & Imaging Sciences, National Institutes of Health, MD 20892, USA. 5. Section on Endocrinology & Genetics, Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, MD 20892, USA.
Abstract
AIM: We aimed to compare the performance of nine adrenal steroids in confirming the correct catheter position during adrenal venous sampling (AVS) without cosyntropin in patients with primary hyperaldosteronism. MATERIALS & METHODS: A successful adrenal vein catheterization without cosyntropin was defined as the ratio of steroids from adrenal to peripheral veins being >3:1. AVS samples from four patients with primary hyperaldosteronism were analyzed. RESULTS: Compared with the mean ratio of cortisol without cosyntropin, the ratios of 11-deoxycortisol (p = 0.008), dehydroepiandrosterone (p = 0.01) and androstenedione (p = 0.008) were significantly higher. None of the ratios (n = 8) of cortisol from adrenal to peripheral veins exceeded 3:1, while all ratios of 11-deoxycortisol (p < 0.001) were >3. CONCLUSION: Cosyntropin infusion during AVS may not be necessary if 11-deoxycortisol is used to confirm catheter position.
AIM: We aimed to compare the performance of nine adrenal steroids in confirming the correct catheter position during adrenal venous sampling (AVS) without cosyntropin in patients with primary hyperaldosteronism. MATERIALS & METHODS: A successful adrenal vein catheterization without cosyntropin was defined as the ratio of steroids from adrenal to peripheral veins being >3:1. AVS samples from four patients with primary hyperaldosteronism were analyzed. RESULTS: Compared with the mean ratio of cortisol without cosyntropin, the ratios of 11-deoxycortisol (p = 0.008), dehydroepiandrosterone (p = 0.01) and androstenedione (p = 0.008) were significantly higher. None of the ratios (n = 8) of cortisol from adrenal to peripheral veins exceeded 3:1, while all ratios of 11-deoxycortisol (p < 0.001) were >3. CONCLUSION: Cosyntropin infusion during AVS may not be necessary if 11-deoxycortisol is used to confirm catheter position.
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