Dexamethasone suppression test abnormalities in multiple sclerosis: relation to ACTH therapy.
We studied the 1-mg overnight dexamethasone suppression test (DST) in patients with MS. In about 50% of patients, serum cortisol did not fall below 5.0 micrograms/dl. This percentage was similar in patients with major depression, but contrasted to 11% in normal controls. MS nonsuppressors were not more depressed than suppressors; dexamethasone bioavailability may have contributed because nonsuppressors had lower serum dexamethasone levels than suppressors. Suppressors improved in the week following ACTH therapy; nonsuppressors did not. Furthermore, serum dexamethasone values correlated positively with clinical response to ACTH treatment. The DST may be a useful neuroendocrine test of glucocorticoid sensitivity in MS patients.
D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D000328:Adult; D003907:Dexamethasone / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009103:Multiple Sclerosis / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*
D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone