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. 2017 May;4(2):75-83.
doi: 10.2217/ije-2016-0020. Epub 2017 Apr 27.

11-Deoxycortisol may be superior to cortisol in confirming a successful adrenal vein catheterization without cosyntropin: a pilot study

Naris Nilubol  1   1 , Steven J Soldin  2   3   2   3 , Dhaval Patel  1   1 , Muthoni Rwenji  2   2 , Jianghong Gu  2   2 , Likhona S Masika  2   2 , Richard Chang  4   4 , Constantine A Stratakis  5   5 , Electron Kebebew  1   1
Affiliations

11-Deoxycortisol may be superior to cortisol in confirming a successful adrenal vein catheterization without cosyntropin: a pilot study

Naris Nilubol et al. Int J Endocr Oncol. 2017 May.

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.

Keywords: 11‐deoxycortisol; adrenal vein sampling; aldosterone; cortisol; cosyntropin; primary hyperaldosteronism.

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Conflict of interest statement

Financial & competing interests disclosure The research activities performed in this manuscript were supported by the Intramural Research Program of the Center for Cancer Research, National Cancer Institute, National Institutes of Health (grant ID 8014165). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. The ratio of steroids from adrenal vein to peripheral vein with and without cosyntropin.
The ratios of steroids from adrenal to peripheral veins before (A) and after cosyntropin infusion (B). The comparisons were made to the ratio of cortisol. * and ** indicate p-value <0.05 and <0.01, respectively. 17-OHPG: 17α-hydroxyprogesterone; DHEA: Dehydropandrosterone.
<b>Figure 2.</b>
Figure 2.. The ratio of aldosterone normalized by steroids from dominant gland to nondominant gland.
The ratios of normalized aldosterone to steroids from dominant to nondominant adrenal glands before (A) and after cosyntropin infusion (B). 17-OHPG: 17α-hydroxyprogesterone; DHEA: Dehydropandrosterone.
See this image and copyright information in PMC

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