Exaggerated Response of Adrenocorticotropic Hormone to Growth Hormone-Releasing Peptide-2 Test in Cushing's Disease —Case Report—

Satoru SAKIHARA; Kazunori KAGEYAMA; Atsufumi MATSUMOTO; Hidetoshi IKEDA; Yuko TSUSHIMA; Maki NARAOKA; Ken TERUI; Takeshi NIGAWARA; Toshihiro SUDA

doi:10.2176/nmc.49.365

Case Reports

Exaggerated Response of Adrenocorticotropic Hormone to Growth Hormone-Releasing Peptide-2 Test in Cushing's Disease

—Case Report—

Satoru SAKIHARA, Kazunori KAGEYAMA, Atsufumi MATSUMOTO, Hidetoshi IKEDA, Yuko TSUSHIMA, Maki NARAOKA, Ken TERUI, Takeshi NIGAWARA, Toshihiro SUDA

Author information

Satoru SAKIHARA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Kazunori KAGEYAMA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Atsufumi MATSUMOTO
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Hidetoshi IKEDA
Research Institute for Pituitary Diseases, Southern Tohoku General Hospital
Yuko TSUSHIMA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Maki NARAOKA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Ken TERUI
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Takeshi NIGAWARA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine
Toshihiro SUDA
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine

Keywords: adrenocorticotropic hormone, corticotropin, hypothalamus, pituitary, stress

JOURNAL OPEN ACCESS

2009 Volume 49 Issue 8 Pages 365-369

DOI https://doi.org/10.2176/nmc.49.365

Details

Abstract

A 47-year-old woman presented with a pituitary microadenoma manifesting as typical Cushing's syndrome. The diagnosis was Cushing's disease based on the endocrinological findings. Plasma adrenocorticotropic hormone (ACTH) levels were greatly increased from 66 pg/ml to 2490 pg/ml (about 38-fold) in response to the administration of 100 μg human growth hormone-releasing peptide (GHRP)-2. GHRP receptor type 1a messenger ribonucleic acid was detected in the tumor. Therefore, GHRP-2 may stimulate ACTH via the GHRP receptor type 1a in pituitary ACTH-producing tumor. The GHRP-2 test, currently clinically available in Japan, may be a useful diagnostic tool for Cushing's disease.

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