A hypothetical index of hypothalamic-pituitary-adrenal (HPA) axis function.
The short ACTH stimulation test (SST) is commonly used by clinicians to determine the integrity of the hypothalamic-pituitary-adrenal (HPA) axis in cases of suspected adrenal insufficiency. Concern has arisen for under-diagnosis of central hypocortisolism using the standard dose (250 mcg) SST with the recent introduction of low-dose (1 mcg) SST as a potentially more sensitive test for central hypocortisolism. Amidst this uncertainty, I will present a novel index hypothesized to extend the sensitivity of the standard dose SST as an adjunctive diagnostic tool for any level of hypocortisolism.
Leow
M K S
MK
Department of Endocrinology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. mleowsj@massmed.org
D000309:Adrenal Insufficiency / Q000097:blood / Q000175:diagnosis*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000465:Algorithms; D004334:Drug Administration Schedule; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008954:Models, Biological; D010900:Pituitary Diseases / Q000175:diagnosis; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D013268:Stimulation, Chemical
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone