Takako Araki1, Jutarat Sangtian2, Darin Ruanpeng2, Ramachandra Tummala3, Brent Clark4, Lynn Burmeister2, Daniel Peterson5, Andrew S Venteicher3, Yasuhiko Kawakami6,7. 1. Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA. taraki@umn.edu. 2. Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA. 3. Department of Neurosurgery, University of Minnesota, 500 SE Harvard St., Minneapolis, MN, 55455, USA. 4. Department of Laboratory Medicine and Pathology, University of Minnesota, 500 SE Harvard St., Minneapolis, MN, 55455, USA. 5. Special Chemistry Laboratory, University of Minnesota Fairview Clinic, 500 SE Harvard St., Minneapolis, MN, 55455, USA. 6. Department of Genetics, Cell Biology and Development, University of Minnesota, 321 Church St. SE., 6-160 Jackson Hall, Minneapolis, MN, 55455, USA. 7. Stem Cell Institute, University of Minnesota, 2001 6th Street SE, Minneapolis, MN, 55455, USA.
Abstract
PURPOSE: Pituitary apoplexy is a rare endocrine emergency. The purpose of this study is to characterize physiological changes involved in pituitary apoplexy, especially during the acute phase. METHODS: A Cushing's disease patient experienced corticotroph releasing hormone (CRH)-induced pituitary apoplexy during inferior petrosal sinus sampling (IPSS). The IPSS blood samples from the Cushing's disease patient were retrospectively analyzed for cytokine markers. For comparison, we also analyzed cytokine markers in blood samples from two pituitary ACTH-secreting microadenoma patients and one patient with an ectopic ACTH-secreting tumor. RESULTS: Acute elevation of interleukin 6 (IL-6) and matrix metalloproteinase 9 (MMP9) was observed in the IPSS blood sample on the apoplectic hemorrhagic site of the tumor. In contrast, such a change was not observed in the blood samples from the contralateral side of the apoplexy patient and in other IPSS samples from two non-apoplexy Cushing's disease patient and a patient with ectopic Cushing's syndrome. CONCLUSION: IL-6 and MMP9 may be involved in the acute process of pituitary apoplexy in Cushing's disease.
PURPOSE: Pituitary apoplexy is a rare endocrine emergency. The purpose of this study is to characterize physiological changes involved in pituitary apoplexy, especially during the acute phase. METHODS: A Cushing's disease patient experienced corticotroph releasing hormone (CRH)-induced pituitary apoplexy during inferior petrosal sinus sampling (IPSS). The IPSS blood samples from the Cushing's disease patient were retrospectively analyzed for cytokine markers. For comparison, we also analyzed cytokine markers in blood samples from two pituitary ACTH-secreting microadenoma patients and one patient with an ectopic ACTH-secreting tumor. RESULTS: Acute elevation of interleukin 6 (IL-6) and matrix metalloproteinase 9 (MMP9) was observed in the IPSS blood sample on the apoplectic hemorrhagic site of the tumor. In contrast, such a change was not observed in the blood samples from the contralateral side of the apoplexy patient and in other IPSS samples from two non-apoplexy Cushing's disease patient and a patient with ectopic Cushing's syndrome. CONCLUSION: IL-6 and MMP9 may be involved in the acute process of pituitary apoplexy in Cushing's disease.
Authors: G A Kaltsas; M G Giannulis; J D Newell-Price; J E Dacie; C Thakkar; F Afshar; J P Monson; A B Grossman; G M Besser; P J Trainer Journal: J Clin Endocrinol Metab Date: 1999-02 Impact factor: 5.958
Authors: R B Sothern; B Roitman-Johnson; E L Kanabrocki; J G Yager; M M Roodell; J A Weatherbee; M R Young; B M Nenchausky; L E Scheving Journal: J Allergy Clin Immunol Date: 1995-05 Impact factor: 10.793