Muestreo de senos petrosos inferiores en el diagnóstico de pacientes con síndrome de Cushing dependiente de hormona adrenocorticotrópica

  • Julián Felipe Montoya Escobar Universidad de Antioquia
  • Carlos Esteban Builes Montaño Universidad de Antioquia
  • Johnayro Gutiérrez Restrepo Universidad de Antioquia, Hospital Pablo Tobón Uribe
  • Germán Campuzano Maya Laboratorio Clínico Hematológico
Palabras clave: síndrome de Cushing, hipersecreción de la hormona adrenocorticotrópica pituitaria, muestreo de seno petroso, hidrocortisona, hormona adrenocorticotrópica.

Resumen

El síndrome de Cushing endógeno es una de las enfermedades más difíciles de estudiar, dado que sus diferentes etiologías requieren una cuidadosa valoración diagnóstica desde el punto de vista clínico, bioquímico y radiológico. Con frecuencia, las características clínicas se solapan con las de enfermedades comunes y algunos pacientes tienen una presentación atípica. Una vez se establece la sospecha clínica, las pruebas bioquímicas de tamizaje permiten definir si existe un estado de hipercortisolismo endógeno; en caso afirmativo, el estudio prosigue con pruebas de laboratorio que ayudan a localizar la causa de la hipercortisolemia. En este punto es fundamental determinar si se trata de un síndrome de Cushing dependiente o no dependiente de hormona adrenocorticotrópica (ACTH) y en caso que sea dependiente, diferenciar entre origen hipofisario y un origen ectópico de la enfermedad. Dicha situación se puede resolver mediante el cateterismo y muestreo de los senos petrosos inferiores, el cual es un procedimiento invasivo y sensible para el diagnóstico diferencial entre el tumor hipofisario y el tumor ectópico secretor de ACTH. En este artículo se revisarán los aspectos generales del diagnóstico del síndrome de Cushing endógeno y luego se presenta una amplia descripción acerca del uso del muestreo venoso central en el subgrupo de pacientes con la forma dependiente de ACTH.

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Biografía del autor/a

Julián Felipe Montoya Escobar, Universidad de Antioquia

Médico Internista, Universidad de Antioquia. Residente de Endocrinología y Metabolismo, Universidad de Antioquia. Medellín, Colombia.

Carlos Esteban Builes Montaño, Universidad de Antioquia

Médico Internista, Universidad Pontificia Bolivariana. Residente de Endocrinología Clínica y Metabolismo, Universidad de Antioquia. Medellín, Colombia.

Johnayro Gutiérrez Restrepo, Universidad de Antioquia, Hospital Pablo Tobón Uribe

Médico Internista y Endocrinólogo, Universidad de Antioquia. Docente del Servicio de Endocrinología y Metabolismo, Universidad de Antioquia. Endocrinólogo Hospital Pablo Tobón Uribe, Medellín, Colombia.

Germán Campuzano Maya, Laboratorio Clínico Hematológico

Médico especialista en Hematología y Patología Clínica. Docente, Ad Honorem, Facultad de Medicina de la Universidad de Antioquia. Médico Director, Laboratorio Clínico Hematológico. Medellín, Colombia.

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Cómo citar
1.
Montoya Escobar JF, Builes Montaño CE, Gutiérrez Restrepo J, Campuzano Maya G. Muestreo de senos petrosos inferiores en el diagnóstico de pacientes con síndrome de Cushing dependiente de hormona adrenocorticotrópica. Med. Lab. [Internet]. 1 de septiembre de 2013 [citado 23 de mayo de 2022];19(9-10):411-50. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/241
Publicado
2013-09-01
Sección
La Clínica y el Laboratorio

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