[Failure of synthcen to diagnose corticotropin insufficiency].
It is commonly believed that a normal cortisol response to exogenous ACTH (synacthen test) reliably indicates, with the exception of states of acute ACTH deprivation, the integrity of hypothalamic-pituitary-adrenocortical function. Published evidence has shown that the synacthen test is not sensitive enough to reveal partial ACTH deficiency leading to a subnormal ACTH response to stress. We report a patient who maintained a normal response to exogenous ACTH stimulation despite symptomatic chronic ACTH deficiency in unstressed conditions. A normal cortisol response in the synacthen test does not therefore exclude the possibility of clinically relevant ACTH deficiency.
Barrande
G
G
Clinique des Maladies Endocriniennes et Métaboliques, Hôpital Cochin, Paris.
Thomopoulos
P
P
Luton
J P
JP
D000309:Adrenal Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D008875:Middle Aged; D010901:Pituitary Function Tests
D006728:Hormones; D000324:Adrenocorticotropic Hormone