Clinical_Rounds_in_Endocrinology_Volume_II_-_Pediatric_Endocrinology

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a

c

b

d

Fig. 4.1 ( a ) A 16-year-old girl with moon facies, acne, lanugo hair, and facial plethora ( b ) Typical wide
violaceous striae. ( c ) CEMRI sella showing hypointense lesion measuring 4.8 × 4 mm ( red arrow ). ( d )
Regression of Cushingoid features after 3 months of transsphenoidal surgery in the same patient

Results of inferior petrosal sinus sampling after human CRH (100 μg) stimulation

Time

(min)

Right central

(RC) ACTH

(pg/ml)

Left central

(LC) ACTH

(pg/ml)

Peripheral

(P) ACTH

(pg/ml)

RC/P

ACTH

ratio

RC/LC

ACTH

ratio

RC/LC-PRL-

adjusted

ACTH ratio

0 75.65 17.29 19.81 3.81 4.37 1.38

2 1516.2 25.55 27.92 54.30 59.34 4.27

3 770.2 41.41 30.55 25.21 18.59 0.94

5 614.0 41.90 51.69 11.87 14.65 0.92

15 701.4 33.54 36.33 19.30 20.91 1.54

4 Childhood Cushing’s Syndrome