{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:16:06Z","timestamp":1778048166080,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,7,24]],"date-time":"2017-07-24T00:00:00Z","timestamp":1500854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Royal Adelaide Hospital Research Committee","award":["8412"],"award-info":[{"award-number":["8412"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>Petrosal venous prolactin concentrations have been promoted to improve the diagnostic accuracy of inferior petrosal sinus sampling (IPSS<\/jats:styled-content>), beyond that achieved with ACTH<\/jats:styled-content> measurement alone, in diagnosing a pituitary ACTH<\/jats:styled-content> source and determining corticotrophinoma side (L\/R). Our objective was to assess the effect of using prolactin to confirm adequacy of petrosal cannulation in a cohort of patients with ACTH<\/jats:styled-content>\u2010dependent Cushing's syndrome.<\/jats:p><\/jats:sec>Design<\/jats:title>Retrospective cohort study.<\/jats:p><\/jats:sec>Patients<\/jats:title>Thirteen patients with clinical and biochemical Cushing's syndrome who underwent IPSS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Measurements<\/jats:title>Serum prolactin and ACTH<\/jats:styled-content> in peripheral and inferior petrosal sinus blood before and after corticotrophin\u2010releasing hormone (CRH<\/jats:styled-content>) injection.<\/jats:p><\/jats:sec>Results<\/jats:title>Thirteen consecutive patients were diagnosed with Cushing's disease using uncorrected ACTH<\/jats:styled-content> ratios. The side of PRL<\/jats:styled-content> excess was the same as the side of ACTH<\/jats:styled-content> excess in all cases. Use of various published prolactin\u2010related equations suggested that the ACTH<\/jats:styled-content> non\u2010dominant side was not cannulated in four, six or seven patients depending on the equation used. The equations generally decreased the central\u2010to\u2010peripheral gradient on the uncorrected ACTH<\/jats:styled-content> dominant side, increased the central\u2010to\u2010peripheral gradient on the contralateral side and diminished or even reversed the ACTH<\/jats:styled-content> intersinus gradient.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Consistent co\u2010lateralisation of prolactin and ACTH<\/jats:styled-content> in IPSS<\/jats:styled-content> strongly suggests that prolactin cannot act as an independent guide to the diagnosis and lateralisation of Cushing's disease. All patients with Cushing's disease had a prolactin intersinus gradient towards the tumourous side of the pituitary, for likely biological reasons. PRL<\/jats:styled-content>\u2010corrected ACTH<\/jats:styled-content> concentrations may threaten the sensitivity and specificity of IPSS<\/jats:styled-content> in diagnosing Cushing's disease and conceal lateralisation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13401","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T08:18:58Z","timestamp":1497860338000},"page":"515-522","source":"Crossref","is-referenced-by-count":24,"title":["Prolactin correction for adequacy of petrosal sinus cannulation may diminish diagnostic accuracy in Cushing's disease"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-6482","authenticated-orcid":false,"given":"Sunita M. C.","family":"De Sousa","sequence":"first","affiliation":[{"name":"Endocrine and Metabolic Unit Royal Adelaide Hospital Adelaide SA Australia"},{"name":"School of Medicine University of Adelaide Adelaide SA Australia"},{"name":"Molecular Pathology Research Laboratory Centre for Cancer Biology an SA Pathology and UniSA alliance Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann I.","family":"McCormack","sequence":"additional","affiliation":[{"name":"Hormones and Cancer Group Garvan Institute of Medical Research Sydney NSW Australia"},{"name":"Department of Endocrinology St Vincent's Hospital Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Endocrinology John Hunter Hospital Newcastle NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David 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