Cosyntropin Research

Fernández Velasco P, Estévez Asensio L, Torres Torres B, Ortolá Buigues A, Gómez Hoyos E, Delgado García E et al.

Adrenal insufficiency (AI) is traditionally diagnosed using the corticotropin stimulation test (CST) with a cortisol threshold of 18.0μg/dL. However, newer immunoassays suggest revising this threshold to enhance diagnostic accuracy. This study aimed to evaluate the diagnostic performance of...

Date K, Baster K, Caunt S, Cohen J, Debono M, Fearnside J et al.

Inadequate production of the essential stress hormone, cortisol, results in adrenal insufficiency (AI), which is associated with significant morbidity and mortality. The current standard diagnostic test for AI is the Short Synacthen Test (SST), but this is both invasive and resource-intensive, in...

Kitayama S, Seki Y, Kato Y, Takano N, Watanabe D, Ichihara A et al.

Adrenal infarction is a rare cause of primary adrenal insufficiency (PAI), typically associated with hypercoagulable states. While PAI usually results from simultaneous bilateral adrenal involvement, progression from unilateral infarction to bilateral disease leading to PAI is rare. We report the...

Dreyer AF, Hansen SB, Borresen SW, Al-Jorani H, Bislev LS, Boesen VB et al.

Glucocorticoid therapy is prescribed for a variety of inflammatory conditions and is associated with severe adverse effects. A glucocorticoid withdrawal syndrome (GWS) may occur after prolonged glucocorticoid treatment-with or without biochemical glucocorticoid-induced adrenal insufficiency (GIAI...

Albasri E, Alghamdi B, Murugan AK, Othman E, Alotaibi S, Dababo MA et al.

Giant prolactinomas are defined as pituitary adenomas (PAs) ≥ 4 cm with plasma prolactin level > 1000 ng/ml with no other co-secretory component. The reasons for development of giant prolactinomas are not clear but genetics play an important pathogenic m...

Almalki MH, Saygili ES, Aboalsamh N, Alghassab A, Alshammari Y, Alali F et al.

Diagnosing central adrenal insufficiency (CAI) is challenging in patients with inconclusive morning cortisol (4-18 µg/dL). Dynamic tests like the short Synacthen test (SST) are imperfect, necessitating reliable tools to stratify CAI risk and reduce diagnostic delays.To develop and val...

Symonds CJ, Leung AA, Kline GA

Screening morning serum cortisol is used to select patients for ACTH stimulation testing to diagnose adrenal insufficiency (AI) but may be affected by pre-analytical factors. Careful consideration to discontinue confounding medications beforehand may preclude the need for subsequent stimulation t...

Sheikh-Ahmad M, Rosenblat I, Salameh S, Dakwar B, Shalata A, Yosefia S et al.

Adrenal insufficiency (AI) often presents with non-specific symptoms such as fatigue, posing a diagnostic challenge in outpatient settings. While the 250 µg short Synacthen test (SST) remains the gold standard for assessing adrenal function, it may be resource-intensive and inconvenient...

Le Loupp AG, Schmitt F, du Roure FD, Beaune G

Dynamic endocrine tests have substantially evolved for the last ten years, corresponding to the first publication about dynamic tests on the website of National College of Biochemistry Hospital (CNBH). These modifications are linked with medical practice and imagery improvement, leading to consid...

Aktas Koc F, Sariakcali B, Sahin A

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease frequently observed in populations along the Eastern Mediterranean coast, characterized by recurrent fever, abdominal pain, and joint inflammation. The disease results from mutations in the MEFV gene, which plays a critic...

Laugesen K, Hansen SB, Bislev LS, Jørgensen JOL, Ladefoged SA

The increased detection of adrenal incidentalomas and drug-induced adrenal insufficiency increases the demand for cortisol testing. While liquid chromatography-tandem mass spectrometry (LC-MS/MS) and dynamic testing remain the gold standard, more expedient tools are needed. We compared the Elecsy...

Mehta R, Lazarus K, Sharma A, Eng PC, Narula K, Choudhury S et al.

Glucocorticoid discontinuation is complicated by glucocorticoid-induced adrenal insufficiency. Guidelines discourage tapering below physiological doses (prednisolone 3-6 mg) when morning cortisol is ≤300 nmol/L, with values <150 nmol/L thought to indicate persistent adrenal insufficienc...

Yeh H, Shrestha S, Corpuz KAH, Paudel S

Adrenal insufficiency (AI) secondary to bilateral adrenal hemorrhage (BAH) from heparin-induced thrombocytopenia (HIT) is rare; only 3 instances of such cases were reported after coronary artery bypass graft surgery (CABG). We report a case of AI due to BAH from HIT after an elective CABG.A 56-ye...

Shanavas Khan S, Yadav R, Maali N, Warrier V, Almezel A

We report the case of a 58-year-old man with psoriasis who developed Addisonian crisis and septic shock following abrupt cessation of long-term, unsupervised use of potent topical corticosteroids, obtained without a prescription. He presented with hypotensive septic shock due to community-acquire...

Vibhatavata P, Mermejo LM, Zhao L, Shields JJ, Turcu AF

Adrenal vein (AV) sampling (AVS) is used to guide therapy in primary aldosteronism (PA). When a single AV is successfully cannulated, the relative aldosterone secretion index (RASI), which compares the aldosterone/cortisol ratio in that AV versus the periphery, has been proposed as sufficient for...

Bashir A, Olaogun I

Cirrhosis is a complex multisystem disorder with significant endocrine, metabolic, and circulatory consequences. One under-recognised complication is hepato-adrenal syndrome, or relative adrenal insufficiency (RAI), where adrenal dysfunction may contribute to haemodynamic instability. Diagnosing ...

Joseph S, Witherow FN, Paul M, Steadman C

Cardiomyopathy is an infrequently reported complication of Addison's disease, which is unique in its reversibility. We report a rare case where cardiomyopathy was the initial manifestation of Addison's disease. This case report explores the pathophysiological association between Addison's disease...

Dziadzko M, Martin P, Bouvet L

Nethathe GD, Cohen J, Lipman J, Anderson R, Hay KE, Pretorius CJ et al.

Glucocorticoid sensitivity varies between individuals, influencing stress and inflammatory responses, however its relationship with the synthetic ACTH [1-24] stimulation test, is not well evaluated. To evaluate glucocorticoid sensitivity and plasma total cortisol (TC) and plasma free cortisol (PF...

Kmieć P, Okroj D, Zdrojewska M, Fiszer J, Zembrzuska S, Świątkowska-Stodulska R et al.

Screening for primary aldosteronism (PA) remains exceedingly low, despite the fact that the disorder contributes to or underlies hypertension (HT) in as many as 20% of unselected patients. Conventionally, withdrawal of medications interfering with the renin‒angiotensin‒aldosterone s...