METHOD FOR DIFFERENTIAL DIAGNOSIS OF PITUITARY INCIDENTALOMA Russian patent published in 2024 - IPC G01N33/53 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to differential diagnosis of incidental pituitary gland. Method involves clinical examination of a patient with diagnosed pituitary adenoma (PA); determining a complex of diagnostically significant parameters, analyzing the obtained data for establishing the morphological type of PA: if the low-dose dexamethasone suppression test (LDDST) is negative, the daily urine free cortisol value is >400 nmol/l, the adrenocorticotrophic hormone value is >10 pg/ml, corticotropinoma is diagnosed; in the absence of a low-dose dexamethasone suppression test (LDDST), the value of cortisol in evening saliva >9.4 nmol/l, concentration of free cortisol in daily urine >400 nmol/l, adrenocorticotrophic hormone value >10 pg/ml is diagnosed with corticotropin; with the value of the test result for PRL taken from a menopausal woman or a man, ≥4000 mU/l is diagnosed with prolactinoma; with the value of the test result for PRL taken from woman on 3^rd–9^th day of the menstrual cycle, ≥4000 mU/l is diagnosed with prolactinoma; at sample value on PRL ≥ 4000 mU/l, samples for monomeric PRL above the norm are diagnosed with prolactinoma; if the IGF-1 concentration is 1.5 times the upper limit of the reference, the laboratory is diagnosed with somatotropin; if the IGF-1 concentration value is less than the upper limit of the reference, the laboratory multiplied by 1.5, if the patient has a history of diabetes mellitus, in the absence of GH suppression in response to hyperglycemia <1 ng/ml, somatotropinoma is diagnosed; if the IGF-1 concentration value is less than the upper limit of the reference, the laboratories multiplied by 1.5, in the absence of diabetes mellitus in the patient's medical history, the GH secretion rhythm is checked for 2 hours at 30-minute intervals, with calculation of the average value of growth hormone, with the obtained value of growth hormone >2.5 ng/ml, somatotropinoma is diagnosed; at values of free T4 >22.0 pmol/l and TSH ≥ 0.4 mU/l is diagnosed with thyrotropin; if the concentration of follicle-stimulating (FSH) and luteinizing (LH) hormones (FSH and LH) in males is >2 mU/l with high testosterone, gonadotropin is diagnosed.

EFFECT: invention provides higher accuracy and objectivity of differential diagnosis of incidental pituitary gland, which enables to give grounded recommendations on treatment and further management of patient on the basis of performed differential diagnosis.

1 cl, 7 dwg, 7 ex, 1 tbl