Value of an ACTH test in assessing hypothalamic-pituitary-adrenocortical function in glucocorticoid-treated patients.
Forty-eight patients receiving glucocorticoid treatment were tested with ACTH stimulation using alpha(1, 24) ACTH (tetracosactrin). All patients subsequently underwent non-acute major surgery without any glucocorticoid administration, and their clinical course and plasma corticosteroids were followed closely. No case of adrenocortical insufficiency was observed. A highly significant correlation was found between the pre-operative adrenocortical response to ACTH and the hypothalmic-pituitary-adrenocortical (H.P.A.) response to surgery. A normal response to ACTH stimulation was never followed by a greatly impaired H.P.A. response to surgery. It seems that a simple ACTH stimulation test is reliable in predicting the integrated H.P.A. response to major stress in glucocorticoid-treated patients.
D000311:Adrenal Glands / Q000503:physiopathology*; D000324:Adrenocorticotropic Hormone; D005938:Glucocorticoids / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology*; D010902:Pituitary Gland / Q000503:physiopathology*; D010912:Pituitary-Adrenal Function Tests; D011241:Prednisone / Q000097:blood; D013514:Surgical Procedures, Operative; D013997:Time Factors
D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D011241:Prednisone