Archived Comments for:
Low immediate postoperative serum-cortisol nadir predicts the short-term, but not long-term, remission after pituitary surgery for Cushing’s disease
Dear Professors. Martin Caraher, Omar Khan Christiana, Naoki Kondo, David Stieb, and Corneel Vandelanotte
Fabiola Costenaro, Universidade Federal do Rio Grande do Sul
7 December 2015
We read with interesting the recent paper of Jon Ramm-Pettersen et al. "Low immediate postoperative serum cortisol nadir predicts the short term, but not long term, remission after pituitary surgery for Cushing's disease" published in this periodic.
We recently have published a prospective study Evaluation of Cushing's disease remission after transsphenoidal surgery based on early serum cortisol dynamics, at Clinical Endocrinology 2014, 80, 411– 418 with different results than this group found. Our study included 106 Cushing's disease patients from a tertiary referral centre, those eighty-six patients had serum cortisol measured at 6, 12, 18, 24 h, 48 h, and 10 to 12 days after transsphenoidal surgery, and received glucocorticoids only in case of adrenal insufficiency, with over 6.0 ± 4.8 years of follow-up. We found in our prospective study, different results of serum cortisol to define surgical remission. An serum cortisol nadir ≤96.6 nM within 48 h after transsphenoidal surgery had sensitivity of 73 percent, specificity and positive predictive value of 100 percent and negative predictive value of 60 percent for Cushing's disease remission. Serum cortisol nadir ≤157.3 nM within 10 to 12 days of transsphenoidal surgery had specificity and positive predictive value of 100 percent and sensitivity of 91 percent negative predictive value of 78 percent for Cushing's disease remission. We also found that a serum cortisol of 55.2nM was not able to predict Cushing's disease short or long term recurrence. Curiously and unfortunately our results were not cited in the present article.
Therefore, we would like to see this letter published with the comments of the authors from Low immediate postoperative serum cortisol nadir predicts the short term, but not long term, remission after pituitary surgery for Cushing's disease about our results and a comparison between them.
Dear Professors. Martin Caraher, Omar Khan Christiana, Naoki Kondo, David Stieb, and Corneel Vandelanotte
7 December 2015
We read with interesting the recent paper of Jon Ramm-Pettersen et al. "Low immediate postoperative serum cortisol nadir predicts the short term, but not long term, remission after pituitary surgery for Cushing's disease" published in this periodic.
We recently have published a prospective study Evaluation of Cushing's disease remission after transsphenoidal surgery based on early serum cortisol dynamics, at Clinical Endocrinology 2014, 80, 411– 418 with different results than this group found. Our study included 106 Cushing's disease patients from a tertiary referral centre, those eighty-six patients had serum cortisol measured at 6, 12, 18, 24 h, 48 h, and 10 to 12 days after transsphenoidal surgery, and received glucocorticoids only in case of adrenal insufficiency, with over 6.0 ± 4.8 years of follow-up. We found in our prospective study, different results of serum cortisol to define surgical remission. An serum cortisol nadir ≤96.6 nM within 48 h after transsphenoidal surgery had sensitivity of 73 percent, specificity and positive predictive value of 100 percent and negative predictive value of 60 percent for Cushing's disease remission. Serum cortisol nadir ≤157.3 nM within 10 to 12 days of transsphenoidal surgery had specificity and positive predictive value of 100 percent and sensitivity of 91 percent negative predictive value of 78 percent for Cushing's disease remission. We also found that a serum cortisol of 55.2nM was not able to predict Cushing's disease short or long term recurrence. Curiously and unfortunately our results were not cited in the present article.
Therefore, we would like to see this letter published with the comments of the authors from Low immediate postoperative serum cortisol nadir predicts the short term, but not long term, remission after pituitary surgery for Cushing's disease about our results and a comparison between them.
Sincerely,
Mauro Czepielewski and co-authors
Email: maurocze@terra.com.br
Competing interests
We declare no competing interests