A combined rapid anterior pituitary evaluation panel or triple bolus test or a dynamic pituitary function test is a medical diagnostic procedure used to assess a patient's pituitary function. A triple bolus test is usually ordered and interpreted by endocrinologists.[citation needed]
| Combined rapid anterior pituitary evaluation panel | |
|---|---|
| OPS-301 code | 1-797 |
In rare cases, it has been associated with pituitary apoplexy.[1]
Process
editThree hormones[2] (usually synthetic analogues) are injected as a bolus into the patient's vein to stimulate the anterior pituitary gland:
The gland's response is assessed by measuring the rise in cortisol and growth hormone (GH) in response to the hypoglycaemia caused by insulin, rises in prolactin and thyroid-stimulating hormone (TSH) caused by TRH and rises in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) caused by GnRH. Blood glucose levels are also monitored to ensure appropriate levels of hypoglycemia are achieved.[citation needed]
History
editThe triple bolus test was introduced in 1973 by physicians from the London Royal Postgraduate Medical School and Queen Elizabeth Hospital, Birmingham.[3] It followed earlier reports combining insulin and vasopressin analogues in the diagnosis of hypopituitarism.[4]
See also
editReferences
edit- ^ Yoshino A, Katayama Y, Watanabe T, et al. (June 2007). "Apoplexy accompanying pituitary adenoma as a complication of preoperative anterior pituitary function tests". Acta Neurochir (Wien). 149 (6): 557–65, discussion 565. doi:10.1007/s00701-007-1155-8. PMID 17468811. S2CID 24978106.
- ^ Melmed, Shlomo (2002). The pituitary. Wiley-Blackwell. pp. 714–. ISBN 978-0-632-04357-6. Retrieved 15 July 2011.
- ^ Harsoulis P, Marshall JC, Kuku SF, Burke CW, London DR, Fraser TR (November 1973). "Combined test for assessment of anterior pituitary function". Br Med J. 4 (5888): 326–9. doi:10.1136/bmj.4.5888.326. PMC 1587416. PMID 4202260.
- ^ Greenwood FC, Landon J (May 1966). "Assessment of hypothalamic pituitary function in endocrine disease". J. Clin. Pathol. 19 (3): 284–92. doi:10.1136/jcp.19.3.284. PMC 473256. PMID 4287115.
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