Abstract
In two cases of Cushing disease diagnosed on the basis of clinical symptoms and laboratory findings with abolished circadian cortisol rhythm the following test were performed: I.V. bolus TRH and LH-RH tests with serum ACTH radioimmunoassay and I.V. infusion cortisol suppression test according to Fehm et al. In female patient A.P., 11 years old, a brisk increase of serum ACTH after LH-RH was noticed, in male patient G.C., 17 years old, increase of serum ACTH after TRH was stated. On the basis of this tests an “intermediate lobe disease” was diagnosed. Additionaly in patient G.C. a paradoxical increase of ACTH during the cortisol infusion, was observed. On the treatment/Parlodel 7 mg/day/a prompt release of symptoms and a significant growth acceleration in both patients were observed. The growth rate in patient G.C. before treatment was 0,8 and during treatment 3,1 cm/year and in patient A.P. 1,8 and 5,8 cm, respectively. As intermediate lobe is under dopaminergic control, response to bromocriptine seems to confirm the intermediate lobe disease in our patients. Authors conclude that bromocriptine treatment can be successful in Cushing disease under the form of intermediate lobe disease as diagnosed on the basis of TRH and/or LH-RH tests.
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Romer, T., Wolska, A. & Klimaszewski, J. 122 BROMOCRIPTINE TREATMENT FOR CUSHING DISEASE UNDER THE FORM OF INTERMEDIATE LOBE DISEASE. Pediatr Res 19, 623 (1985). https://doi.org/10.1203/00006450-198506000-00142
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DOI: https://doi.org/10.1203/00006450-198506000-00142