Clinical review 62: Laboratory assessment of adrenal insufficiency.
Abstract
S K Grinspoon, B M Biller; Clinical review 62: Laboratory assessment of adrenal insufficiency, The Journal of Clinical Endocrinology & Metabolism, Volume 79, Is
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The corticotropin stimulation test is a superior diagnostic test with higher sensitivity and specificity than morning cortisol and ACTH for diagnosing PAI.
“Although it is more elaborate and requires endocrinological expertise, the corticotropin stimulation test is a superior diagnostic test with a higher degree of sensitivity and specificity than determination of morning cortisol and ACTH concentrations and is therefore preferred in all patients considered with the differential diagnosis of PAI (28,38).”
From Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [28]
The 18 μg/dL cortisol cutoff threshold is based on older serum cortisol assays.
“This threshold is based on older serum cortisol assays.”
From New Cutoffs for the Biochemical Diagnosis of Adrenal Insufficiency after ACTH Stimulation using Specific Cortisol Assays (2021) · cites this paper as [11]
No absolute cortisol cutoff for the ACTH stimulation test is perfect for the diagnosis of AI.
“As with any endocrine test, no absolute cortisol cutoff for the ACTH stimulation test is perfect for the diagnosis of AI [4, 7, 11, 12].”
From New Cutoffs for the Biochemical Diagnosis of Adrenal Insufficiency after ACTH Stimulation using Specific Cortisol Assays (2021) · cites this paper as [11]
Varying cutoffs for basal cortisol levels have been suggested to predict AI.
“Varying cutoffs for basal cortisol levels have been suggested to predict AI [11, 17-19, 41].”
From New Cutoffs for the Biochemical Diagnosis of Adrenal Insufficiency after ACTH Stimulation using Specific Cortisol Assays (2021) · cites this paper as [11]
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References 31 · Cited by 442
- Authors
- Grinspoon, S. K., & Biller, B. M.
- Affiliations
- Massachusetts General Hospital (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1994-10
- Volume
- 79
- Issue
- 4
- Pages
- 923-931
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2039022629
- Cited by
- 442
- References
- 31
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 13 · 2017: 12 · 2016: 12 · 2015: 9 · 2014: 16 · 2013: 20 · 2012: 13
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (RR 01066, M01RR001066)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
- Keywords
- adrenal insufficiency, laboratory diagnosis, ACTH stimulation test, cortisol measurement, adrenocortical function testing
- MeSH terms
- Adrenal Insufficiency, Adrenocorticotropic Hormone, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Clinical Laboratory Techniques
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