Comparison of low-dose and high-dose cosyntropin stimulation testing in children

Pediatrics International : Official Journal of the Japan Pediatric Society
Ayse Pinar CemerogluMichael A Wood

Abstract

There is no consensus among pediatric endocrinologists in using low-dose (LD) versus high-dose (HD) cosyntropin to test for secondary/tertiary adrenal insufficiency. This paper compares LD and HD cosyntropin stimulation testing in children for evaluation of hypothalamic-pituitary-adrenal axis (HPAA) and suggests a new peak cortisol cut-off value for LD stimulation testing to avoid false positivity. Data of 36 children receiving LD (1 µg) and HD (249 µg) cosyntropin consecutively during growth hormone (GH) stimulation testing were analyzed in two groups. Group A were patients who passed GH stimulation testing and were not on oral, inhaled or intranasal steroids (intact hypothalamic-pituitary axis, n= 19). Group B were patients who failed GH stimulation testing and/or were on oral, inhaled or intranasal steroids (impaired hypothalamic-pituitary axis, n= 17). In group A, the mean peak cortisol response in LD cosyntropin was 18.5 ± 2.4 µg/dL and that for the HD cosyntropin was 24.8 ± 3.1 µg/dL (r: 0.76, P≤ 0.05). In group B, the mean peak cortisol response in LD cosyntropin was 15.7 ± 6.1 µg/dL and that for HD cosyntropin was 21.7 ± 7.9 µg/dL (r: 0.98, P≤ 0.05). When a standard cut-off of 18 µg/dL was used, 37% of the patients with...Continue Reading

References

Apr 1, 1991·The Journal of Clinical Endocrinology and Metabolism·G DicksteinM Lahav
Apr 1, 1995·The Journal of Clinical Endocrinology and Metabolism·J BroideY Weisman
Jan 1, 1997·The Journal of Clinical Endocrinology and Metabolism·G Dickstein, C Shechner

❮ Previous
Next ❯

Citations

May 7, 2013·Pediatric Annals·Christopher SchnellerElizabeth Littlejohn
Apr 17, 2015·Journal of Pediatric Endocrinology & Metabolism : JPEM·Ayse Pinar CemerogluLora Kleis
Apr 17, 2016·Archives of Disease in Childhood·Julie ParkJoanne Blair
May 29, 2019·The Journal of Clinical Endocrinology and Metabolism·Elisa VaianiAlicia Belgorosky

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addison Disease

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.