Erratum to: Comparison of salivary and calculated free cortisol levels during low and standard dose of ACTH stimulation tests in healthy volunteers

Objective: Systemic amyloidosis may affect many organs, and may cause endocrinologic problems which may result in adrenal insufficiency. However, assessment of adrenocortical reserve is challenging in amyloidosis patients with renal involvement. We aimed to evaluate adrenocortical reserve with various methods of cortisol measurement to determine any occult clinical condition. Methods: Patients with renal amyloidosis and healthy subjects were evaluated in this cross-sectional study. Basal cortisol, corticosteroid-binding globulin (CBG), and albumin levels were measured. Serum free cortisol (cFC) level was calculated. Cortisol response tests performed after ACTH stimulation test (250 μg, intravenously) were evaluated, and free cortisol index (FCI) was calculated. Results: Twenty renal amyloidosis patients, and 25 healthy control subjects were included in the study. Patients and control subjects had similar median serum baseline cortisol levels [258 (126-423) vs 350 (314-391) nmol/L, p=0.169)] whereas patients’ stimulated cortisol levels at the 60th minute were lower [624 (497-685) vs 743 (674-781) nmol/L, p=0.011)]. The 60th-minute total cortisol levels of 8 of the 20 (40%) amyloidosis patients were <500 nmol/L, but only three of these 8 patients had stimulated FCI <12 nmol/mg suggesting an adrenal insufficiency (15%). Conclusion: ACTH stimulation test and cortisol measurements should be considered in renal amyloidosis patients with severe proteinuria to avoid false positive results if only ACTH stimulation test is used. It will be appropriate to evaluate this group of patients together with estimated measurements as FCI.

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Prediction of Adrenocortical Insufficiency After Pituitary Adenoma Surgery Using Postoperative Basal Cortisol Levels

Physiological Research ◽

10.33549/physiolres.932875 ◽

2015 ◽

pp. 531-536 ◽

Cited By ~ 1

Author(s):

V. HÁNA ◽

J. JEŽKOVÁ ◽

M. KOSÁK ◽

M. KRŠEK ◽

J. MAREK ◽

...

Keyword(s):

Pituitary Adenoma ◽

Standard Dose ◽

Tolerance Test ◽

Minimal Risk ◽

Adrenocortical Insufficiency ◽

Insulin Tolerance ◽

Basal Cortisol ◽

Stimulation Tests ◽

Basal Cortisol Level ◽

Cortisol Levels

Our aim was to analyze the correlation of early postoperative cortisol levels in patients after transsphenoidal pituitary adenoma surgery compared to the standard dose ACTH test and Insulin tolerance test (ITT) several months later. We retrospectively reviewed data from 94 patients operated for pituitary adenoma in years 2009-2012. The comparison of day 7 (median) postoperative basal cortisol levels and 3.6 months (median) after pituitary adenoma surgery stimulation test – standard dose 250 µg 1-24ACTH test in 83 patients or ITT in 11 patients were performed. All 16 patients with early postoperative cortisol levels >500 nmol/l proved a sufficient response in the stimulation tests. At basal cortisol levels of 370-500 nmol/l the sufficient response was found in 96 % (27/28) of patients. In the postoperative basal cortisol levels 200-370 nmol/l we found a preserved corticotroph axis later on in 88 % (28/32) of cases. Patients with basal cortisol levels 100-200 nmol/l had a maintained corticotroph axis function in 8/11 cases – 73 %. All patients with an early postoperative basal cortisol level above 500 nmol/l proved in the stimulation tests a preserved corticotroph axis function. The interval 370-500 nmol/l showed a minimal risk of postoperative adrenal insufficiency.

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ACTH Stimulation Test for Adrenal Insufficiency with Free Cortisol Levels

The Cleveland Clinic Manual of Dynamic Endocrine Testing ◽

10.1007/978-3-319-13048-4_2 ◽

2015 ◽

pp. 7-10

Author(s):

Ahmet Bahadir Ergin ◽

Amir H. Hamrahian ◽

A. Laurence Kennedy ◽

Manjula K. Gupta

Keyword(s):

Adrenal Insufficiency ◽

Stimulation Test ◽

Acth Stimulation Test ◽

Acth Stimulation ◽

Free Cortisol ◽

Cortisol Levels

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Total and free cortisol levels during 1 μg, 25 μg, and 250 μg cosyntropin stimulation tests compared to insulin tolerance test: results of a randomized, prospective, pilot study

Endocrine ◽

10.1007/s12020-017-1371-9 ◽

2017 ◽

Vol 57 (3) ◽

pp. 388-393 ◽

Cited By ~ 3

Author(s):

Seenia Peechakara ◽

James Bena ◽

Nigel J. Clarke ◽

Michael J. McPhaul ◽

Richard E. Reitz ◽

...

Keyword(s):

Pilot Study ◽

Tolerance Test ◽

Insulin Tolerance Test ◽

Test Results ◽

Prospective Pilot Study ◽

Insulin Tolerance ◽

Free Cortisol ◽

Stimulation Tests ◽

Cortisol Levels

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A Comparison Between the Effects of Low (1 μg) and Standard Dose (250 μg) ACTH Stimulation Tests on Adrenal Cortex Functions with Leprosy Patients

Endocrine Research ◽

10.1080/07435800500449478 ◽

2005 ◽

Vol 31 (4) ◽

pp. 325-333 ◽

Cited By ~ 1

Author(s):

Ramis Çolak ◽

Yusuf Ozkan ◽

Serife Erdogan Önen ◽

Yunus Saral ◽

Ihsan Halifeoglu

Keyword(s):

Adrenal Cortex ◽

Standard Dose ◽

Acth Stimulation ◽

Leprosy Patients ◽

Stimulation Tests

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A comparison between the effects of low dose (1 microg) and standard dose (250 microg) ACTH stimulation tests on adrenal P450c17alpha enzyme activity in women with polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje.0.1470473 ◽

2002 ◽

pp. 473-477 ◽

Cited By ~ 10

Author(s):

R Colak ◽

F Kelestimur ◽

K Unluhizarci ◽

F Bayram ◽

Y Sahin ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Low Dose ◽

Polycystic Ovary ◽

Standard Dose ◽

Acth Stimulation Test ◽

Acth Stimulation ◽

Ovary Syndrome ◽

Healthy Women ◽

Stimulation Tests ◽

Cortisol Responses

OBJECTIVE: Numerous studies have found elevated androgen production by the adrenal glands in patients with polycystic ovary syndrome (PCOS). However, the role and the mechanisms responsible for the adrenal androgen excess in women with PCOS are not well understood. DESIGN: Our aim was to compare 17-hydroxyprogesterone (17-OHP), androstenedione, dehydroepiandrosterone sulfate (DHEAS) and cortisol responses to a low dose (1 microg) ACTH stimulation test (LDT) with the responses to a standard dose (250 microg) ACTH stimulation test (SDT) in patients with PCOS. METHODS: Fifty women with PCOS (mean age 25.4+/-0.7 years) and 20 healthy women (mean age 27.3+/-2.2 years) were included in the study. The patients and controls underwent ACTH stimulation tests with 1 microg and 250 microg synthetic ACTH in the follicular phase of their cycles. Venous blood was drawn at 0, 30 and 60 min for determination of serum cortisol, 17-OHP, androstenedione and DHEAS levels. RESULTS: In PCOS subjects, peak and area under the curve (AUC) 17-OHP (9.3+/-0.3 nmol/l, 378.4+/-61 nmol/lx60 min), androstenedione (15.6+/-0.6 nmol/l, 806.4+/-52 nmol/lx60 min) and DHEAS (7.5+/-0.4 micromol/l, 385.6+/-25.5 micromol/lx60 min) responses to SDT were significantly higher than the levels in healthy women (respectively 5.7+/-0.3 nmol/l and 249.4+/-52.2 nmol/lx60 min for 17-OHP; 9.1+/-0.3 nmol/l and 413.7+/-31.6 nmol/lx60 min for androstenedione; 4.3+/-0.4 micromol/l and 224.9+/-24.5 micromol/lx60 min for DHEAS) (P<0.05). Peak and AUC cortisol responses to SDT were similar in PCOS and control subjects. Peak and AUC cortisol and 17-OHP responses to LDT in women with PCOS were similar to the values obtained in healthy women. Peak androstenedione (12.5+/-0.6 nmol/l) and peak (6.5+/-0.5 nmol/l) and AUC (336.3+/-22.4 micromol/lx60 min) DHEAS responses to LDT were significantly higher in women with PCOS. CONCLUSIONS: These results show that LDT is capable of revealing the adrenal hyperactivity in women with PCOS. Adrenal P450c17alpha enzyme dysregulation in PCOS is revealed by ACTH stimulation at a pharmacological dose (250 microg) but not by a physiological dose (1 microg). LDT is able to demonstrate adrenal hyperactivity characterized by an increase in DHEAS levels.

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