The low-dose ACTH test does not identify mild insufficiency of the hypothalamic-pituitary-adrenal axis in children with inadequate stress response

Journal of Pediatric Endocrinology and Metabolism

Volumn 23, Issue 11, 2010, Pages 1097-1104

  Kamrath, Clemens ^a   Boehles, Hansjosef ^a  

^a GOETHE UNIVERSITY   (Germany)

Author keywords

Acth test; Adrenal insufficiency; Adrenocorticotropin insufficiency; Hypothalamicpituitary adrenal axis insufficiency; Insulin tolerance test; LDAT; Low dose acth test; Secondary adrenal insufficiency; Secondary hypoadrenalism; Synacthen test

Indexed keywords

CORTICOTROPIN; HYDROCORTISONE;

ADRENAL INSUFFICIENCY; CHILD; CLINICAL ARTICLE; DIAGNOSTIC ACCURACY; DISEASE SEVERITY; FEMALE; HORMONAL REGULATION; HUMAN; HYDROCORTISONE BLOOD LEVEL; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; LOW DRUG DOSE; MALE; RETROSPECTIVE STUDY; REVIEW; SCREENING TEST; SENSITIVITY AND SPECIFICITY; STRESS;

ADOLESCENT; ADRENAL INSUFFICIENCY; ADRENOCORTICOTROPIC HORMONE; CHILD; CHILD, PRESCHOOL; FEMALE; HUMANS; HYDROCORTISONE; HYPOTHALAMO-HYPOPHYSEAL SYSTEM; INSULIN RESISTANCE; MALE; PITUITARY DISEASES; PITUITARY-ADRENAL SYSTEM; RETROSPECTIVE STUDIES; SENSITIVITY AND SPECIFICITY; STRESS, PSYCHOLOGICAL;

EID: 78650528807     PISSN: 0334018X     EISSN: None     Source Type: Journal    
DOI: 10.1515/jpem.2010.174     Document Type: Review

References (37)

1. Reimondo G, Bovio S, Allasino B, Terzolo M , Angeli A: Secondary hypoadrenalism. Pituitary 2008;11:147-154
2. Walvoord E.C. Rosenman M.B. Eugster E.A. Prevalence of adrenocorticotropin deficiency in children with idiopathic growth hormone deficiency Journal of Clinical Endocrinology and Metabolism 2004 89 10 5030-5034 DOI 10.1210/jc.2004-0364 2. Walvoord EC, Rosenman MB, Eugster EA: Prevalence of adrenocorticotropin deficiency in children with idiopathic growth hormone deficiency. J Clin Endocrinol Metab 2004; 89:5030-5034 (Pubitemid 39391444)
3. Lange M, Feldt-Rasmussen U, Svendsen OL, Kastrup KW, Juul A, Müller J: High risk of adrenal insufficiency in adults previously treated for idiopathic childhood onset growth hormone deficiency. J Clin Endocrinol Metab 2003; 88:57845789.
4. Taback SP, Dean HJ: Mortality in Canadian children with growth hormone (GH) deficiency receiving GH therapy 1967-1992. The Canadian Growth Hormone Advisory Committee. J Clin Endocrinol Metab 1996; 81: 1693-1696
5. Grinspoon SK, Biller BM: Laboratory assessment of adrenal insufficiency. J Clin Endocrinol Metab 1994; 79:923-931
6. Shah A, Stanhope R, Matthew D: Hazards of pharmacological tests of growth hormone secretion in childhood. BMJ 1992;304:173-174
7. Binder G. Bosk A. Gass M. Ranke M.B. Heidemann P.H. Insulin tolerance test causes hypokalaemia and can provoke cardiac arrhythmias Hormone Research 2004 62 2 84-87 DOI 10.1159/000079539 7. Binder G, Bosk A, Gass M, Ranke MB, Heidemann P: Insulin tolerance test causes hypokalemia and can provoke cardiac arrhythmias. Horm Res 2004; 62: 84-87 (Pubitemid 39274257)
8. Lindholm J, Kehlet H, Blichert-Toft M, Dinesen B, Riishede J: Reliability of the 30-minute ACTH test in assessing Hypothalamic-pifuitary-adrenal function. Clin Endocrinol 1978; 47: 272-274
9. Gleeson HK, Walker BR, Seckl JR, Padfield PL: Ten years on: Safety of short synacthen tests in assessing adrenocorticotropin deficiency in clinical practice. J Clin Endocrinol Metab 2003; 88: 2106-11
10. Agha A. Tomlinson J.W. Clark P.M. Holder G. Stewart P.M. The long-term predictive accuracy of the short Synacthen (corticotropin) stimulation test for assessment of the hypothalamic-pituitary-adrenal axis Journal of Clinical Endocrinology and Metabolism 2006 91 1 43-47 http://jcem.endojournals.org/cgi/ reprint/91/1/43 DOI 10.1210/jc.2005-1131 10. Agha A, Tomlinson JW, Clark PM, Holder G, Stewart PM: The long-term predictive accuracy of the short synacthen (corticotropin) stimulation test for assessment of the hypothalamic-pituitary- adrenal axis. J Clin Endocrinol Metab 2006; 91: 43-47 (Pubitemid 43069115)
11. Lindholm J, Kehlet H: Re-evaluation of the clinical value of the 30 min ACTH test in assessing the hypothalamic-pituitary-adrenocortical function. Clin Endocrinol 1987;26:53-59
12. Weintrob N. Sprecher E. Josefsberg Z. Weininger C. Aurbach-Klipper Y. Lazard D. Karp M. Pertzelan A. Standard and low-dose short adrenocorticotropin test compared with insulin-induced hypoglycemia for assessment of the hypothalamic-pituitary- adrenal axis in children with idiopathic multiple pituitary hormone deficiencies Journal of Clinical Endocrinology and Metabolism 1998 83 1 88-92 DOI 10.1210/jc.83.1.88 12. Weintrob N, Sprecher E, Josefsberg Z, Weininger N, Aurbach-Klipper Y, Lazard D, Karp M, Pertzelan A: Standard and low-dose short adrenocorticotropin test compared with insulininduced hypoglycemia for assessment of the hypothalamic-pituitary-adrenal axis in children with idiopathic multiple pituitary hormone deficiencies. J Clin Endocrinol Metab 1998; 83: 88-92 (Pubitemid 28498315)
13. Mayenknecht J, Diedrich S, Bahr V, Plockinger U, Oelkers W: Comparison of low and high G corticotropin stimulation tests in patients with pituitary diseases. J Clin Endocrinol Metab 1998; 83: 1558-1562
14. Borst GC, Michenfelder HJ, O'Brian JT: Discordant Cortisol response to exogenous ACTH and insulininduced hypoglycaemia in patients with pituitary disease. N Engl J Med 1982; 24: 1462-1464
15. Cunningham SK, Moore A, McKenna TJ: Normal Cortisol response to corticotropin in patients with secondary adrenal failure. Arch Int Med 1983; 143: 2276-2279
16. Soule SG, Fahle-Wilson M, Tomlinson S: Failure of the short ACTH test to unequivocally diagnose longstanding symptomatic hypoadrenalism. Clin Endocrinol 1996; 44: 137-140
17. Streeten DHP, Anderson GH, Bonaventura MM: The potential for serious consequences from misinterpreting normal responses to the rapid adrenocorticotropin test. J Clin Endocrinol Metab 1996;81:285-290
18. Suliman A.M. Smith T.P. Labib M. Fiad T.M. McKenna T.J. The low-dose ACTH test does not provide a useful assessment of the hypothalamic-pituitary-adrenal axis in secondary adrenal insufficiency Clinical Endocrinology 2002 56 4 533-539 DOI 10.1046/j.1365-2265.2002.01509.x 18. Suliman AM, Smith TP, Labib M, Fiad TM, McKenna TJ: The low-dose ACTH test does not provide a useful assessment of the hypothalamicpituitary-adrenal axis in secondary adrenal insufficiency. Clin Endocrinol 2002; 56: 533-539 (Pubitemid 34429629)
19. Crowley S, Hindmarsh PC, Honour JW, Brook CGD: The use of low doses of ACTH in the investigation of adrenal unction in man. J Endocrinol 1991; 130: 475479
20. Dickstein G, Shechner C, Nicholson WE, Rosner I, Shen-Orr Z, Adawi F, Lahav M: Adrenocorticotropin stimulation: effects of basal Cortisol level, time of the day, and suggested new sensitive low dose test. J Clin Endocrinol Metab 1991; 72: 773-778
21. Tordjman K, Jaffe A, Trostanetsky Y, Greenman Y, Limor R, Stern N: Low-dose (1 microgram) adrenocorticotrophin (ACTH) stimulation as a screening test for impaired hypothalamo-pituitaryadrenal axis function: sensitivity, specificity and accuracy in comparison with the high-dose (250 microgram) test.-Clin Endocrinol (Oxf) 2000; 52: 633-640
22. Rasmuson S. Olsson T. Hagg E. A low dose ACTH test to assess the function of the hypothalamic-pituitary-adrenal axis Clinical Endocrinology 1996 44 2 151-156 22. Rasmuson S, Olsson T, Hagg E: A low dose ACTH test to assess the function of the hypothalamicpituitary-adrenal axis. Clin Endocrinol 1996; 44: 151156 (Pubitemid 26042968)
23. Abdu TAM, Elhadd TA, Neary R, Clayton RN: Comparison of the low dose short synacthen test (1 (ig), the conventional dose short synacthen test (250 Hg), and the insulin tolerance test for the assessment of the hypothalamo-pituitary- adrenal axis in patients with pituitary disease. J Clin Endocrinol Metab 1999; 84: 838-843
24. Thaler LM, Blevins LS: The low dose (1 μg) adrenocorticotropin stimulation test in the evaluation of patients with suspected central adrenal insufficiency. J Clin Endocrinol Metab 1998; 83: 2726-2729
25. Rose SR, Lustig RH, Burstein S, Pitukcheewanont P, Broome DC, Burghen GA: Diagnosis of ACTH deficiency. Comparison of overnight metyrapone test to either low-dose or high-dose ACTH test. Horm Res. 1999; 52: 73-79
26. Giordano R, Picu A, Bonelli L, Balbo M, Berardelli R, Marinazzo E, Corneli G, Ghigo E, Arvat E: Hypothalamus-pituitary-adrenal axis evaluation in patients with hypothalamo-pituitary disorders: comparison of different provocative tests. Clin Endocrinol 2008; 68: 934-941
27. Maghnie M, Uga E, Temporini F, Di Iorgi N, Secco A, Tinelli C, Papalia A, Casini MR, Loche S: Evaluation of adrenal function in patients with growth hormone deficiency and hypothalamicpituitary disorders: comparison between insulininduced hypoglycemia, low-dose ACTH, standard ACTH and CRH stimulation tests. Eur J Endocrinol 2005;152:735-741
28. Gone EN, Kandemir N, Kinik ST: Significance of low-dose and standard-dose ACTH tests compared to overnight metyrapone test in the diagnosis of adrenal insufficiency in childhood. Horm Res 2003; 60:191197
29. Jonetz-Mentzel L. Wiedemann G. Establishment of reference ranges for cortisol in neonates, infants, children and adolescents European Journal of Clinical Chemistry and Clinical Biochemistry 1993 31 8 525-529 29. Jonetz-Mentzel L, Wiedemann G: Establishment of reference ranges for Cortisol in neonates, infants, children and adolescents. J Clin Chem Clin Biochem 1993;27: 525-529 (Pubitemid 23262824)
30. Plumpton FS, Besser GM: The adrenocortical response to surgery and insulin-induced hypoglycaemia in corticosteroidtreated and normal subjects. Br J Surg 1969; 56:216-219
31. Shankar RR, Jakacki RI, Haider A, Lee MW, Pescovitz OH: Testing the hypothalamic-pituitaryadrenal axis in survivors of childhood brain and skull-based tumors. J Clin Endocrinol Metab. 1997; 82: 1995-1998
32. Reinken L, van Oost G: Longitudinal physical development of healthy children 0 to 18 years of age. Body length/height, body weight and growth velocity. Klin Padiatr 1992; 204:129-133
33. Brandt I, Reinken L: The growth rate of healthy children in the first 16 years: Bonn-Dortmund longitudinal developmental study. Klin Padiatr 1988; 200:451-456
34. Dorin RI, Quails CR, Crapo LM: Diagnosis of adrenal insufficiency. Ann Intern Med. 2003; 139: 194-204
35. Ambrosi B. Barbetta L. Re T. Passini E. Faglia G. The one microgram adrenocorticotropin test in the assessment of hypothalamic-pituitary-adrenal function European Journal of Endocrinology 1998 139 6 575-579 DOI 10.1530/eje.0.1390575 35. Ambrosi B, Barbetta L, Re T, Passini E, Faglia G: The one microgram adrenocorticotropin test in the assessment of hypothalamic- pituitary-adrenal function. Eur J Endocrinol 1998; 139: 575-579 (Pubitemid 29030392)
36. Nye EJ, Grice JE, Hockings GI, Strakosch CR, Crosbie GV, Walters MM, Jackson RV: Comparison of adrenocorticotropin (ACTH) stimulation tests and insulin hypoglycemia in normal humans: low dose, standard high dose, and 8-hour ACTH-(I-24) infusion tests. J Clin Endocrinol Metab 1999; 84: 3648-3655
37. Oelkers W, Boelke T, Bahr V: Dose-response relationships between plasma adrenocorticotropin (ACTH), Cortisol, aldosterone and 18-hydroxycorticosterone after injection of ACTH (139) or human corticotropin-releasing hormone in man. J Clin Endocrinol Metab 1988; 66: 181-186