Comparison of the low dose short synacthen test (1 μg), the conventional dose short synacthen test (250 μg), and the insulin tolerance test for assessment of the hypothalamo-pituitary-adrenal axis in patients with pituitary disease

Journal of Clinical Endocrinology and Metabolism

Volumn 84, Issue 3, 1999, Pages 838-843

  Abdu, T A M ^a   Elhadd, T A ^b   Neary, R ^b   Clayton, R N ^b  

^a CITY GENERAL HOSPITAL   (United Kingdom)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

CORTICOTROPIN; GLUCOSE; HYDROCORTISONE; INSULIN; TETRACOSACTIDE;

ADULT; AGED; ARTICLE; CLINICAL ARTICLE; DIAGNOSTIC VALUE; HORMONE DETERMINATION; HORMONE RELEASE; HORMONE RESPONSE; HUMAN; HYPOPHYSIS DISEASE; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; INSULIN TOLERANCE TEST; INTERMETHOD COMPARISON; MEDICAL EXAMINATION; PRIORITY JOURNAL; STEROID THERAPY; STRESS;

EID: 0033062851     PISSN: 0021972X     EISSN: None     Source Type: Journal    
DOI: 10.1210/jcem.84.3.5535     Document Type: Article

References (34)

1. Greenwood FC, Landon J, Stamp TCB. 1966 The plasma sugar, free fatty acid, cortisol and growth hormone response to insulin in control subjects. J Clin Invest. 45:429-436.
2. Jacobs HS, Nabarro JDN. 1969 Test of hypothalamopituitary adrenal function in man. Q J Med. 152:475-491.
3. Edwards CRW, Besser GM. 1974 Diseases of the hypothalamas and pituitary gland. J Clin Endocrinol Metab. 3:475-505.
4. Hurel SG, Thompson CJ, Watson MJ, Harris NM, Baylis PH, Kendal-Taylor P. 1996 Audit of short synacthen and insulin stress tests in the assessment of the hypothalamo-pituitary-adrenal axis. Clin Endocrinol (Oxf). 44:141-146.
5. Lindholm J, Kehlet H, Blichert-Toft M, Dinesen B, Riishede J. 1978 Reliability of the 30 minute ACTH test in assessing hypothalamic pituitary adrenal axis function. J Clin Endocrinol Metab. 47:272-274.
6. Stewart, P.M, Corrie J, Seckl JR, Edwards CRW, Padfield PL. 1988 A rational approach for assessing the hypothalamo-pituitary-adrenal axis. Lancet. 1:1208-1210.
7. Lindholm J, Kehlet H. 1987 Re-evaluation of the clinical value of the 30 min ACTH test in assessing the hypothalamic-pituitary-adrenocortical function. Clin Endocrinol (Oxf). 26:53-59.
8. Hagg E, Hassel U, Lithner F, Asplund K. 1981 Hypothalamo-pituitary-adrenal function: can a short ACTH test replace insulin tolerance test [Abstract]? Lakaridningen. 78:4027-4030.
9. Kane KF, Emery P, Sheppard MC, Stewart PM. 1995 Assessing the hypothalamo-pituitary-adrenal axis in patients on long-term glucocorticoid therapy: the short synacthen test vs. the insulin tolerance test. Q J Med. 88:263-267.
10. Davies MJ, Howlett TA. 1996 A survey of the current methods used in the UK to assess pituitary function. J R Soc Med. 89:159-164.
11. Cunningham SK, Moore A, Mckenna TJ. 1983 Normal cortisol response to corticotrophin in patients with secondary adrenal failure. Arch Intern Med. 143:2276-2279.
12. Soule SG, Fahie-Wilson M, Tomlinson S. 1996 Failure of the short ACTH test to unequivocally diagnose longstanding symptomatic hypoadrenalism. Clin Endocrinol (Oxf). 44:137-140.
13. Littley MD, Shalet SM, Beardwell CG. 1994 The short synacthen test in patients with insidious onset ACTH deficiency. J Endocrinol. 140(Suppl):159.
14. Streeten, DHP, Anderson GH, Bonaventyra MM. 1996 The potential for serious consequences from misinterpreting normal responses to the rapid adrenocorticotrophin test. J Clin Endocrinol Metab. 81:285-290.
15. Ammari F, Issa BG, Millward E, Scanlon MF. 1996 A comparison between the short ACTH and insulin stress test for assessing hypothalamo-pituitary-adrenal function. Clin Endocrinol (Oxf). 44:473-476.
16. Crowley S, Hindmarsh PC, Honour JW, Brook CGD. 1992 Reproducibility of the cortisol response to stimulation with a low dose of ACTH(1-24): the effect of basal cortisol levels and comparison of low-dose with high dose secretary dynamics. J Endocrinol. 136:167-172.
17. Daidoh H, Morita H, Mune T, et al. 1995 Responses of plasma adrenocortical steroids to low dose ACTH in normal subjects. Clin Endocrinol (Oxf). 43:311-315.
18. Dickstein G, Shechner C, Nicholson WE, Rosner I, Shen-Orr Z, Adawai F, Lahav M. 1991 Adrenocorticotrophin stimulation test: effects of basal cortisol level, time of day, and suggested new sensitive low dose test. J Clin Endocrinol Metab. 72:773-778.
19. Tordjman K, Jaffe A, Grazas N, Apter C, Stern N. 1995 The role of the low dose (1 μg) adrenocorticotrophin test in the evaluation of patients with pituitary diseases. J Clin Endocrinol Metab. 80:1301-1305.
20. Talwar V, Lodha S, Dash RJ. 1998 Assessing the hypothalamo-piruitary-adrenocortical axis using physiological doses of adrenocorticotrophic hormone. Q J Med. 91:285-290.
21. Mayenkmecht J, Diederich S, Bahr V, Plochinger, Olkers W. 1998 Comparison of low and high dose corticotrophin stimulation test in patients with pituitary disease. J Clin Endocrinol Metab. 80:1558-1562.
22. Weintrob N, Sprecher E, Josefsberg Z, et al. 1998 Standard and low dose short adrenocortictrophin test compared with insulin-induced hypoglycaemia for assessment of the hypothalamo-pituitary-adrenal axis in children with idiopathic multible pituitary hormone deficeincies. J Clin Endocrinol Metab. 83:88-92.
23. Plumpton FS, Besser GM. 1969 The adrenocortical response to surgery and insulin induced hypoglycaemia in corticosteroid treated subjects. Br J Surg. 56:216-219.
24. Moore A, Aitken R, Burke C, Gaskell S, Groom G, Holder G, Selby C, Wood P. 1985 Cortisol assays: guidelines for the provision of a clinical biochemstry service. Ann Clin Biochem, 22:435-454.
25. Orme SM, Peacy SR, Barth JH, Belchetz PE. Comparison of tests of stress-released cortisol secretion in pituitary disease. Clin Endocrinol (Oxf). 45:135-140.
26. Wood JB, James VHT, Frankland AW, Landon J. 1965 A rapid test of adrenocortical function. Lancet. 1:243.
27. Patel SR, Selby C, Jeffcoate WJ. 1991 The short synacthen test in acute hospital admissions. Clin Endocrinol (Oxf). 35:259-261.
28. Vestergarad P, Hoeck HC, Jakobsen PE, Laurberg P. 1997 Reproducibility of growth hormone and Cortisol responses to the insulin tolerance test and the short ACTH test in normal adults. Horm Metab Res. 29:106-110.
29. Tsatsoulis A, Shalet SM, Harrison J, Ratcliffe WA, Beardwell CG, Robinson L. 1988 Adrenocorticotrophin (ACTH) deficiency undetected by standard dynamic tests of the hypothalamo-pituitary-adrenal axis. Clin Endocrinol (Oxf). 28:225-232.
30. Banger V, Clayton RN. 1998 How reliable is the short synacthen test for the investigation of the HPA axis in patients with pituitary disease. Eur J Endocrinol. 139:580-583.
31. Clayton RN. 1996 Short synacthen test vs. insulin stress test for the assessment of the hypothalamo-pituitary-adrenal axis: controversy revisited. Clin Endocrinol (Oxf). 44:147-149.
32. Crowley S, Hindmarsh PC, Holownia P, Honour JW, Brook CGD. 1991 The use of low doses of ACTH in the investigation of adrenal function in man. J Endocrinol. 130:75-479.
33. Rasmuson S, Olsson T, Hagg E. 1996 A low dose ACTH test to assess the function of the hypothalamo-pituitary-adrenal axis. Clin Endocrinol (Oxf). 44:151-156.
34. Thaler LM, Blevins Jr LS. 1998 The low dose (1-μg) adrenocorticotrophin stimulation test in the evaluation of patients with suspected central adrenal insufficiency. J Clin Endocrinol Metab. 83:2726-2729.