Intramuscular Short-term ACTH Test for the Determination of Adrenal Function in Children: Safe, Effective and Reliable

Özsu, Elif; Şıklar, Zeynep; Bilici, Esra; Ceran, Ayşegül; Uyanık, Rukiye; Çetin, Tuğba; Aycan, Zehra; Berberoğlu, Merih

doi:10.4274/jcrpe.galenos.2019.2019.0099

Cited by 1 publication

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“…As regards the route of administration most studies were conducted using the IV route, but corticotropin analogs requested for the IV test are not readily available in all countries and although data are limited and mostly obtained in pediatric cohorts the test conducted with intramuscular (IM) long-acting adrenocorticotropic hormone seems to be safe, effective, and reliable in cosintropin the diagnosis of SAI [ 26 , 27 ].…”

Section: How To Perform the Testmentioning

confidence: 99%

ACTH Stimulation Test for the Diagnosis of Secondary Adrenal Insufficiency: Light and Shadow

et al. 2023

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Secondary Adrenal Insufficiency (SAI) is a condition characterized by inappropriately low ACTH secretion due to a disease or injury to the hypothalamus or the pituitary. The evaluation when suspected is often challenging for the non-specific symptoms, the rarity of the disease, and the pitfalls associated with laboratory tests. A prompt and correct diagnosis of SAI is essential because although an adequate hormonal replacement therapy could be lifesaving, inappropriate life-long therapy with steroids can be harmful. The gold standard test for assessing the hypothalamus-pituitary-adrenal axis (HPA) is the insulin tolerance test (ITT), but due to safety issues is not widely used. Conversely, the ACTH stimulation test is a safer and well-tolerated tool for SAI diagnosis. However, data about its diagnostic accuracy show great variability due to both technical and interpretative aspects, such as dose, route of administration, the timing of the test, and assay used for cortisol measurements. Consequently, the clinical background of the patient and the pretest probability of HPA axis impairment become of paramount importance. We aimed to summarize the recent literature evidence in the conduction and interpretation of the ACTH stimulation test for the diagnosis of SAI to provide updated insights on its correct use in clinical practice.

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Section: How To Perform the Testmentioning

confidence: 99%