Thank you for all the helpful answers.
Bristol is still on AssyFinder but they had to stop providing this test
some time ago.
Options suggested included doing immunocytochemistry and maybe in situ
hybridisation for CRH and CRHmRNA. If these were negative, then
pituitary surgery would definitely be her best bet.
Javier Gomez
-----Original Message-----
On 22 Jul 2011, at 11:05, Javier Gomez wrote:
> Hello,
> Can anyone analyse CRH? It is not in Assay Finder, and I already have
contacted some endocrine labs.
>
> This is an interesting patient, who has now had three cutaneous
neuroendocrine tumours resected which were thought originally to be
isolated, but may in fact be metastatic deposits from a small bowel
primary. There are still a couple of lesions visible on cross sectional
imaging, but octerotide and MIBG scanning are both negative.
> Over the last few months she has also developed ACTH dependent
Cushing's, with the pituitary being confirmed as the source of ACTH
although her pituitary imaging is unimpressive. Though this could be
explained by MEN1 - a pituitary and neuroendocrine tumour, though no
parathyroid disease detected). An alternative explanation is that her
neuroendocrine tumour is secreting CRH driving her otherwise normal
pituitary to oversecrete ACTH etc.
> She has been referred for pituitary surgery but if she has ongoing
ectopic CRH production, it might be that it should cancelled or adrenal
surgery considered instead.
>
> Many thanks,
> Javier Gomez
>
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