Rapid adrenocorticotropic hormone test in practice. Retrospective review.
Retrospective analysis of the rapid adrenocorticotropic hormone (ACTH) test in a large adult population shows a marked interdependence of the basal cortisol concentration, peak cortisol concentration, and increase in cortisol concentration. Repetition of the rapid ACTH test in the same patient does not improve diagnostic accuracy. A significant number of falsely abnormal rapid ACTH test results were observed (in comparison to continuous ACTH infusion as a reference test). This supports the use of the rapid ACTH test as a screening test, but not as a diagnostic test for adrenocortical failure. It is proposed that a peak cortisol level greater than or equal to 20 micrograms/dl (550 nmol/liter) is a sufficient single criterion for normal adrenal function as assessed by the rapid ACTH test.
D000304:Adrenal Cortex Function Tests / Q000379:methods; D000309:Adrenal Insufficiency / Q000175:diagnosis*; D000324:Adrenocorticotropic Hormone; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D012016:Reference Values; D012189:Retrospective Studies; D013997:Time Factors
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone