We review the clinical and biochemical criteria used for evaluation of the transsphenoidal pituitary surgery results in the treatment of Cushing’s disease (CD). Firstly, we discuss the pathophysiology of the hypothalamic-pituitary-adrenal axis in normal subjects and patients with CD. Considering the series published in the last 25 years, we observed a significant variation in the remission or cure criteria, including the choice of biochemical tests, timing, threshold values to define remission, and the interference of glucocorticoid replacement or previous treatment. […]

Hospitalization and sickness are known as possible interference factors on the neuroendocrine (pituitary-adrenal) response to stimulation tests. To evaluate this response, we studied 11 hospitalized children (mean age: 5.4 ± 3.3 years). The stimuluation test using ovine corticotropin-releasing hormone (CRH; 1 ±g/kg) was performed at 8:00 am. Blood samples were collected at 0, 30, 60, and 90 min after CRH injection, to measure ACTH and cortisol. No adverse effect related to the use of CRH was observed. Basal levels of […]