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Letters |1 September 1998

Jugular Vein Sampling in Cushing Disease

Leonard Thaler, MD

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Author, Article, and Disclosure Information
  • Emory University; Atlanta, GA 30322
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TO THE EDITOR:
Doppman and colleagues [1] describe a potentially valuable diagnostic tool for characterizing adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. However, apparent inconsistencies between the data described in the text and the figure cause confusion. The Results section reports that the range for pre-corticotropin-releasing hormone (CRH) ratios of central to peripheral ACTH in the jugular vein samples is 2.1 to 3.7. However, the figure and Discussion section indicate that several values are less than 2.0. Likewise, the range for post-CRH ratios in the jugular vein samples is noted to be 3.24 to 14.9, with evidence from the figure indicating several values less than 3.0. A similar discrepancy exists for the petrosal sinus samples. Ranges for pre- and post-CRH ACTH are reported to be 2.2 to 110.5 and 12.7 to 407.1, respectively, but the figure shows one value for pre-CRH ACTH that is less than 2.0 and one for post-CRH that is less than 3.0. According to the ranges provided in the Results section, all samples would indicate an ACTH-secreting pituitary adenoma, but this is obviously not the case.
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Thaler L. Jugular Vein Sampling in Cushing Disease. Ann Intern Med. 1998;129:423–424. doi: 10.7326/0003-4819-129-5-199809010-00020

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Published: Ann Intern Med. 1998;129(5):423-424.

DOI: 10.7326/0003-4819-129-5-199809010-00020

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