Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency.
A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing.
Hägg
E
E
Department of Medicine, University Hospital, Umeå, Sweden.
Asplund
K
K
Lithner
F
F
D000293:Adolescent; D000309:Adrenal Insufficiency / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007328:Insulin; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D013997:Time Factors
D007328:Insulin; D006854:Hydrocortisone