I. Determine whether Cushing's syndrome and stress-induced pseudo-Cushing's syndrome can be
differentiated by evaluating endogenous corticotropin-releasing hormone activity.
PROTOCOL OUTLINE: Patients undergo a 30-hour infusion of deuterated cortisol with peripheral
and petrosal vein measurements of adrenocorticotropin hormone (ACTH) and
corticotropin-releasing hormone (CRH). Patients also have a 2-day, low-dose dexamethasone
Patients with ACTH tumors are referred for pituitary surgery as indicated. Patients without
Cushing's syndrome are entered as controls. During scheduled radiologic procedures, these
subjects undergo ACTH and CRH sampling from the petrosal vein or cavernous sinus following a
deuterated cortisol infusion.
PROTOCOL ENTRY CRITERIA:
Suspected adrenocorticotropin hormone (ACTH)-dependent Cushing's syndrome No pregnant
women Effective contraception required of fertile women