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ABSTRACT In primary adrenal insufficiency plasma ACTH values are 5-10 times above the upper normal limit (80-100 pg/ml) and allow a confirmation of the diagnosis even during substitution
therapy. Clearly elevated ACTH levels (mean 720 pg/ml) are found in 50% of treated CAH patients. In cushing's disease ACTH concentrations at or above 500 pg/ml of plasma are found. The
ACTH-response to a 3 hour metyrapone test was compared between 18 steroid treated patients (29 tests) and 21 tests performed for growth retardation. The tests were analysed based on the
following criteria: basal ACTH, < 50-100 pg/ml, increase ≥ 50 pg/ml, maximum ≥ 100 pg/ml. Cortisol basal value 6-13 μg%, compound-S increase ≥ 4 μg%. In steroid treated patients a normal
function was found in 4 tests and signs of incomplete recovery in 10 tests. In 6 tests a partial insufficiency was diagnosed. A complete suppression was found in 4 tests. ACTH adrenal
function during and after steroid treatment appears to be largely unpredictable. The metyrapone test is valuable in assessing ACTH adrenal function in suspected secondary insufficiences.
Plasma ACTH concentrations without stimulation are helpful for the diagnosis of primary adrenal insufficiency of cushing's disease and for the biochemical control of congenital adrenal
hyperplasia. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Depts. of Pediatrics, Universities of Basel and Bern, Switzerland J Girard, J B Baumann & K Zuppinger Authors * J
Girard View author publications You can also search for this author inPubMed Google Scholar * J B Baumann View author publications You can also search for this author inPubMed Google Scholar
* K Zuppinger View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE
Girard, J., Baumann, J. & Zuppinger, K. Assessment of ACTH-Adrenal Activity and Diagnostic Value of Plasma ACTH. _Pediatr Res_ 13, 1196 (1979).
https://doi.org/10.1203/00006450-197910000-00093 Download citation * Issue Date: 01 October 1979 * DOI: https://doi.org/10.1203/00006450-197910000-00093 SHARE THIS ARTICLE Anyone you share
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