title: How much is enough? Evaluation of adrenal function in children who undergo growth hormone stimulation test.
abstract: The objective was to determine the probability of receiving steroid treatment following an insulin tolerance test (ITT) for short-stature evaluation and to evaluate the utility of a subsequent cortrosyn stimulation test (CST) in determining adrenal sufficiency. We retrospectively analyzed the hypothalamic-pituitary-adrenal (HPA) axis evaluation in short-stature subjects during the 5-year period from January 2005 to December 2009. The probability of receiving steroid treatment was < 10% when the maximum cortisol concentration during an ITT was < 8.4 microg/dL. In the event of a suboptimal cortisol response during an ITT, only a single 1-microg CST is recommended for assessment of adrenal function.
authors.affiliation: Ian Burr Division of Pediatric Endocrinology, Vanderbilt University Medical School, Nashville, TN 37232, USA. revi.mathew@vanderbilt.edu
authors.forename: Revi P
authors.initials: RP
authors.lastname: Mathewi
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Duffy
authors.forename: Wenli
authors.initials: W
authors.lastname: Wang
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Saville
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Bremer
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000502:physiology*; D002648:Child; D003000:Clonidine / Q000008:administration & dosage / Q000494:pharmacology; D003366:Cosyntropin / Q000008:administration & dosage* / Q000494:pharmacology; D003940:Diagnostic Techniques, Endocrine / Q000592:standards*; D004305:Dose-Response Relationship, Drug; D019382:Human Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000502:physiology; D008797:Metyrapone / Q000008:administration & dosage / Q000494:pharmacology; D008954:Models, Biological; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000502:physiology; D012016:Reference Values; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone; D003366:Cosyntropin; D003000:Clonidine; D006854:Hydrocortisone; D008797:Metyrapone