Evaluating the usefulness of plasma chromogranin A measurement in cyclic ACTH-dependent Cushing's syndrome.

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  • Additional Information
    • Source:
      Publisher: Japan Endocrine Society Country of Publication: Japan NLM ID: 9313485 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1348-4540 (Electronic) Linking ISSN: 09188959 NLM ISO Abbreviation: Endocr J Subsets: MEDLINE
    • Publication Information:
      Original Publication: Tokyo : Japan Endocrine Society, [1993-
    • Subject Terms:
      Chromogranin A*/blood ; Cushing Syndrome*/diagnosis ; Cushing Syndrome*/blood ; Adrenocorticotropic Hormone*/blood ; Adrenocorticotropic Hormone*/metabolism ; Carcinoid Tumor*/blood ; Carcinoid Tumor*/diagnosis ; Carcinoid Tumor*/complications ; Carcinoid Tumor*/metabolism ; ACTH Syndrome, Ectopic*/diagnosis ; ACTH Syndrome, Ectopic*/blood; Humans ; Female ; Aged ; Lung Neoplasms/diagnosis ; Lung Neoplasms/blood ; Lung Neoplasms/complications ; Retrospective Studies ; Male ; Middle Aged
    • Abstract:
      Cushing's syndrome, a clinical condition characterized by hypercortisolemia, exhibits distinct clinical signs and is associated with cyclic cortisol secretion in some patients. The clinical presentation of cyclic Cushing's syndrome can be ambiguous and its diagnosis is often challenging. We experienced a 72-year-old woman with cyclic ACTH-dependent Cushing's syndrome caused by a pulmonary carcinoid tumor. Diagnosis was challenging because of the extended trough periods, and the responsible lesion was initially unidentified. A subsequent follow-up computed tomography revealed a pulmonary lesion, and ectopic ACTH secretion from this lesion was confirmed by pulmonary artery sampling. Despite the short peak secretion period of ACTH (approximately one week), immunostaining of the surgically removed tumor confirmed ACTH positivity. Interestingly, stored plasma chromogranin A levels were elevated during both peak and trough periods. The experience in evaluating this patient prompted us to investigate the potential use of plasma chromogranin A as a diagnostic marker of ACTH-dependent Cushing's syndrome. A retrospective study was conducted to determine the efficacy of plasma chromogranin A in three patients with ectopic ACTH syndrome (EAS), including the present case, and six patients with Cushing's disease (CD) who visited our hospital between 2018 and 2021. Notably, plasma chromogranin A levels were higher in patients with EAS than in those with CD. Additionally, a chromogranin A level in the present case during the trough phase was lower than that in the peak phase, and was similar to those in CD patients. The measurement of plasma chromogranin A levels could aid in differentiating EAS from CD.
    • Contributed Indexing:
      Keywords: ACTH-dependent Cushing’s syndrome; Carcinoid; Chromogranin A; Cyclic; Pulmonary arterial sampling
    • Accession Number:
      0 (Chromogranin A)
      9002-60-2 (Adrenocorticotropic Hormone)
    • Publication Date:
      Date Created: 20240626 Date Completed: 20241002 Latest Revision: 20241003
    • Publication Date:
      20250114
    • Accession Number:
      10.1507/endocrj.EJ24-0128
    • Accession Number:
      38925945