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Corticotropin Stimulation Test

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41. A Single, Post-ACTH Cortisol Measurement to Screen for Adrenal Insufficiency in the Hospitalized Patient. Full Text available with Trip Pro

A Single, Post-ACTH Cortisol Measurement to Screen for Adrenal Insufficiency in the Hospitalized Patient. Cosyntropin stimulation testing (CST) is used to screen patients for adrenal insufficiency (AI). Traditionally, CST includes baseline cortisol concentration, the administration of cosyntropin, and cortisol concentration at 30 and 60 minutes poststimulation. There is debate surrounding the utility of testing and cut-off points for concentrations at each time point.To determine if a single (...) cortisol measurement at 30 or 60 minutes could replace the traditional approach.looked retrospectively at inpatients who underwent standard, high-dose CST (n = 702) and evaluated the number of patients who would screen positive for AI by using a single time point (30 or 60 minutes) compared with the traditional CST.A tertiary-care, academic medical center.Hospital inpatients present between January 2012 and September 2013.Of tests, 84.3% were normal, which was defined as at least 1 cortisol

2018 Journal of Hospital Medicine

42. Nucleus accumbens deep-brain stimulation efficacy in ACTH-pretreated rats: alterations in mitochondrial function relate to antidepressant-like effects Full Text available with Trip Pro

Nucleus accumbens deep-brain stimulation efficacy in ACTH-pretreated rats: alterations in mitochondrial function relate to antidepressant-like effects Mitochondrial dysfunction has a critical role in the pathophysiology of mood disorders and treatment response. To investigate this, we established an animal model exhibiting a state of antidepressant treatment resistance in male Wistar rats using 21 days of adrenocorticotropic hormone (ACTH) administration (100 μg per day). First, the effect (...) of ACTH treatment on the efficacy of imipramine (10 mg kg(-1)) was investigated alongside its effect on the prefrontal cortex (PFC) mitochondrial function. Second, we examined the mood-regulatory actions of chronic (7 day) high-frequency nucleus accumbens (NAc) deep-brain stimulation (DBS; 130 Hz, 100 μA, 90 μS) and concomitant PFC mitochondrial function. Antidepressant-like responses were assessed in the open field test (OFT) and forced swim test (FST) for both conditions. ACTH pretreatment prevented

2016 Translational psychiatry

43. ACTH stimulation test

ACTH stimulation test Synacthen Test Produced by In partnership with User Top Links Menu Search User Top Links Search Synacthen Test Also Known As ACTH stimulation test, short synacthen test, SST Formal Name Synacthen This article was last reviewed on 21 April 2017. This article was last modified on 26 October 2017. At a Glance Why Get Tested? To help diagnose . To assess and gland function. When To Get Tested? When a doctor suspects that the adrenal gland is not producing enough . When (...) a doctor suspects that the pituitary gland is not producing enough adrenocorticotrophic hormone ( ). Sample Required? A blood sample is collected and then a small amount of synacthen is injected into a vein or muscle. A further blood sample is taken after 30 minutes and/or 60 minutes. Test Preparation Needed? Exogenous steroids (glucocorticoids) should be stopped at least 24 hours before the test e.g. prednisolone, and inhaled steroids should not be taken the morning of the test. Those taking oestrogen

2012 Lab Tests Online UK

44. LC-MS/MS based determination of basal- and ACTH-stimulated plasma concentrations of 11 steroid hormones: implications for detecting heterozygote CYP21A2 mutation carriers. Full Text available with Trip Pro

LC-MS/MS based determination of basal- and ACTH-stimulated plasma concentrations of 11 steroid hormones: implications for detecting heterozygote CYP21A2 mutation carriers. Heterozygosity in 21-hydroxylase deficiency (21OHD) has been associated with hyperandrogenemic symptoms in children and adults. Moreover, the carrier status is mandatory for genetic counseling. We aimed at defining a hormonal parameter for carrier detection by mass spectrometry.Eleven basal and ACTH-stimulated steroid (...) hormones of heterozygous carriers of CYP21A2 mutations and control individuals were compared.Hormones were determined in plasma samples by liquid chromatography tandem mass spectrometry (LC-MS/MS) in 58 carriers (35 males, 23 females, age range 6-78 years) and 44 random controls (25 males, 19 females, age range 8-58 years).Heterozygotes could be identified best applying the 17-hydroxyprogesterone+21-deoxycortisol/cortisol×1000 ((17OHP+21S)/F×1000) equation 30  min after ACTH injection. An optimal cut

2015 European Journal of Endocrinology

45. Clinical Utility of the Adrenocorticotropin Stimulation Test with/without Dexamethasone Suppression for Definitive and Subtype Diagnosis of Primary Aldosteronism Full Text available with Trip Pro

Clinical Utility of the Adrenocorticotropin Stimulation Test with/without Dexamethasone Suppression for Definitive and Subtype Diagnosis of Primary Aldosteronism The adrenocorticotropin (ACTH) stimulation test (AST) has been reported to be useful for diagnosing primary aldosteronism (PA), particularly for differentiating PA subtypes under 1-mg dexamethasone suppression (DS). The aim of our study was to clarify the effect of 1-mg DS on AST results. A retrospective cohort study was conducted (...) using data for 48 patients (PA: 30/48). We estimated the difference in plasma aldosterone concentration (PAC) responsiveness to ACTH stimulation with single (AST alone) and combined (AST under 1-mg DS) tests within the same patient. We compared the diagnostic accuracy of these two tests for PA and the laterality of hyperaldosteronism. We found no differences in PAC responsiveness to ACTH stimulation between single and combined tests, and observed a significant positive linear relationship (30 min, R

2017 International journal of molecular sciences

46. Cortisol Response to Low Dose Cosyntropin Stimulation Test in the Late Afternoon

or disease Intervention/treatment Phase Adrenal Insufficiency Diagnostic Test: low-dose cosyntropin stimulation test Not Applicable Detailed Description: In earlier studies investigators claimed that subnormal cortisol response using plastic tubes might result from cosyntropin adherence to the tube and loss of the delivered dosage. It was shown that 21.6-58.6% of ACTH dosage had not been recovered when pushed through 20.3 cm plastic tube, and loss of ACTH may be up to 70% when cosyntropin was delivered (...) and Interventions Go to Arm Intervention/treatment Experimental: healthy subjects 20 healthy subjects will undergo low dose cosyntropin stimulation test. Serum and salivary cortisol will be measured just before cosyntropin administration and 30 minutes later. Diagnostic Test: low-dose cosyntropin stimulation test Each subject recruited in the study will undergo low dose cosyntropin stimulation test via intravenous short 2.5 cm plastic tube. 1 μg/ml ACTH aliquot stock solution will be pushed through, followed

2017 Clinical Trials

47. Salivary Free Cortisol Response to Cosyntropin Stimulation Test in Mitotane Treated Patients

: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Experimental: healthy subjects low-dose cosyntropin stimulation test Diagnostic Test: Cosyntropin stimulation test At 0800h to 0900h, a 25 mm plastic intravenous line will be inserted in an antecubital vein. Then, 1 μg/ml ACTH aliquot stock solution will be pushed through, followed by 5 ml physiologic saline (0.9%). Serum cortisol and salivary free cortisol will measured just before ACTH administration and 30 minutes later (...) . Experimental: hypoadrenal mitotane treated patients low-dose cosyntropin stimulation test Diagnostic Test: Cosyntropin stimulation test At 0800h to 0900h, a 25 mm plastic intravenous line will be inserted in an antecubital vein. Then, 1 μg/ml ACTH aliquot stock solution will be pushed through, followed by 5 ml physiologic saline (0.9%). Serum cortisol and salivary free cortisol will measured just before ACTH administration and 30 minutes later. Experimental: hypoadrenal no-mitotane treated patients low

2017 Clinical Trials

48. Corticotrophin stimulation tests. Full Text available with Trip Pro

Corticotrophin stimulation tests. 4293797 1968 01 19 2018 11 13 0035-9157 60 9 1967 Sep Proceedings of the Royal Society of Medicine Proc. R. Soc. Med. Corticotrophin stimulation tests. 908 Greig W R WR Boyle J A JA Jasani M K MK Maxwell J D JD eng Journal Article England Proc R Soc Med 7505890 0035-9157 9002-60-2 Adrenocorticotropic Hormone WI4X0X7BPJ Hydrocortisone IM Adolescent Adrenocorticotropic Hormone Adult Aged Child Female Fluorometry Humans Hydrocortisone blood Middle Aged Pituitary (...) -Adrenal Function Tests Pregnancy 1967 9 1 1967 9 1 0 1 1967 9 1 0 0 ppublish 4293797 PMC1902006 J Endocrinol. 1966 Mar;34(3):411-2 5931917 J Clin Endocrinol Metab. 1956 Aug;16(8):1059-74 13345863

1967 Proceedings of the Royal Society of Medicine

49. ACTH after 15 minutes distinguishes between Cushing's disease and ectopic Cushing's syndrome: A proposal for a short and simple CRH test. Full Text available with Trip Pro

ACTH after 15 minutes distinguishes between Cushing's disease and ectopic Cushing's syndrome: A proposal for a short and simple CRH test. The aim of the present study was to validate criteria of corticotropin-releasing hormone (CRH) stimulation and 8 mg dexamethasone suppression (high-dose dexamethasone suppression, HDDS) to distinguish the etiology of ACTH-dependent Cushing's syndrome.We retrospectively analyzed cortisol and ACTH after the injection of 100 μg human CRH in confirmed Cushing's (...) of 14.0, a sensitivity of 83%, a specificity of 94%, a positive predictive value of 98% and a negative predictive value of 58%. All of the other criteria of stimulated ACTH and cortisol levels were not superior in predicting CD in response to CRH injection. The addition of cortisol suppression by dexamethasone did not increase the discriminatory power. However, the combination of a positive ACTH response at 15 min and a positive HDDS test excluded ECS in all cases.The present findings support the use

2015 European Journal of Endocrinology

50. Corticotropin Stimulation Test

Stimulation Test Corticotropin Stimulation Test Aka: Corticotropin Stimulation Test , Cosyntropin Stimulation Test , ACTH Stimulation Test II. Indications evaluation 8am level decreased III. Technique Obtain Baseline Labs Plasma Adrenocorticotropic Hormone (ACTH) Level level Plasma aldosterone Plasma renin activity Administer cosyntropin (ACTH) Administer ACTH 250 mcg IV Repeat Obtain at 30 and 60 minutes after IV ACTH IV. Interpretation Low cortisol level (<18 mcg/dl) and high plasma ACTH (>50 pg/ml (...) ) Primary Low cortisol level (<18 mcg/dl) and low plasma ACTH Secondary V. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Corticotropin Stimulation Test." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: adrenocorticotropic hormone stimulation panels (lab test) (C2097251) Concepts Laboratory Procedure ( T059 ) CPT 1011190 English

2015 FP Notebook

51. Primary hypothyroidism and isolated ACTH deficiency induced by nivolumab therapy: Case report and review. Full Text available with Trip Pro

monitoring showed elevated thyroid-stimulating hormone and low free thyroxine after the 6th administration of nivolumab. After the 12th administration, he developed general fatigue, recurrent hypoglycemia, and relative hypotension. Laboratory tests showed low sodium, low morning cortisol without correspondence increase of corticotrophin (ACTH). Other pituitary hormones were normal. MRI showed no space-occupying lesions, but heterogeneous enhancement of the pituitary gland.Primary hypothyroidism (...) Primary hypothyroidism and isolated ACTH deficiency induced by nivolumab therapy: Case report and review. Nivolumab is a monoclonal IgG antibody blocking programmed death receptor-1 (PD1), leading to restoration of the natural T-cell-mediated immune response against the cancer cells. However, it also causes plenty of autoimmune-related adverse events, which often involves endocrine system.A 54-year-old male with renal clear cell carcinoma was treated with nivolumab intravenously. Routine

2017 Medicine

52. Pulsatile Cortisol Feedback on ACTH Secretion Is Mediated by the Glucocorticoid Receptor and Modulated by Gender. Full Text available with Trip Pro

Pulsatile Cortisol Feedback on ACTH Secretion Is Mediated by the Glucocorticoid Receptor and Modulated by Gender. Factors that regulate physiological feedback by pulses of glucocorticoids on the hypothalamic-pituitary unit are sparsely defined in humans in relation to gluco- or mineralocorticoid receptor pathways, gender, age, and the sex steroid milieu.The objective of the study was to test (the clinical hypothesis) that glucocorticoid (GR) and mineralocorticoid (MR) receptor-selective (...) with negative feedback on both ACTH burst mass and secretion regularity. Eplerenone, an MR antagonist, exerted no detectable effect on the same parameters. Despite feedback imposition, CRH-arginine vasopressin-stimulated ACTH secretion was also increased by mifepristone and not by eplerenone. Withdrawal vs addback of sex steroids had no effect on ACTH secretion parameters. Nonetheless, ACTH secretion was greater (P = .006) and more regular (P = .004) in men than women.Pulsatile cortisol feedback on ACTH

2017 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

53. Normalized early post-operative cortisol and ACTH values predict nonremission after surgery for Cushing's disease. Full Text available with Trip Pro

Normalized early post-operative cortisol and ACTH values predict nonremission after surgery for Cushing's disease. Perioperative increases in adrenocorticotropic hormone (ACTH) and cortisol mimic results of corticotropin-releasing hormone (CRH) stimulation testing. This phenomenon may help identify patients with residual adenoma after transsphenoidal surgery (TSS) for Cushing disease (CD).To predict nonremission after TSS for CD.Retrospective case-control study of patients treated at a single (...) center from December 2003 until July 2016. Early and medium-term remission were assessed at 10 days and 11 months.Two hundred and ninety-one consecutive TSS cases from 257 patients with biochemical evidence of CD seen at a clinical center.Normalized early postoperative values (NEPVs) for cortisol and ACTH were calculated as immediate postoperative cortisol or ACTH levels minus preoperative post-CRH-stimulation test levels.Prediction of early nonremission was evaluated using logistic regression

2017 Journal of Clinical Endocrinology and Metabolism

54. Study of H.P. ACTHAR Subcutaneous Gelatin (Gel)(Highly Purified Gel Injection) in Uveitis Patients

Intermediate Uveitis Posterior Uveitis Scleritis Clinically Significant Macular Edema Drug: H.P. ACTHAR SUBCUTANEOUS GEL INJECTION Phase 4 Detailed Description: Uveitis represents a heterogeneous group of diseases that results from ocular inflammatory reaction involving ocular tissue and vasculature. The inflammation usually causes pain, redness, photophobia and blurred vision. H.P Acthar Gel stimulate the adrenal cortex to secrete cortisol. Additionally H.P. Acthar gel is also reported to bind (...) relevant MeSH terms: Layout table for MeSH terms Macular Edema Uveitis Uveitis, Anterior Iridocyclitis Uveitis, Posterior Uveitis, Intermediate Pars Planitis Scleritis Macular Degeneration Retinal Degeneration Retinal Diseases Eye Diseases Uveal Diseases Panuveitis Iris Diseases Choroiditis Choroid Diseases Scleral Diseases Adrenocorticotropic Hormone Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs

2016 Clinical Trials

55. [Relative adrenal insufficiency in septic shock: comparison of the response to hydrocortisone in patients diagnosed through random cortisol measurement versus corticotropin test]. (Abstract)

[Relative adrenal insufficiency in septic shock: comparison of the response to hydrocortisone in patients diagnosed through random cortisol measurement versus corticotropin test]. The incidence of relative adrenal insufficiency (RAI) in patients with septic shock is high and has a significant impact on survival. The purpose of this study was to determine whether a random cortisol concentration < 25 mg/dL was as good as a low dose (1 mg) corticotrophin stimulation test in the diagnosis of RAI (...) in patients with septic shock as assessed by the hemodynamic response to hydrocortisone.Patients were randomized to a single cortisol determination or to a low dose corticotrophin stimulation test. After blood collection to cortisol determinations, hydrocortisone (100 mg every 8 hrs) was administered for all patients in the first 36 hours. RAI was defined by a random cortisol concentration < 25 mg/dL or a D cortisol concentration < 9 mg/dL in the corticotrophin test.Sixty patients (G1 = 30; G2 = 30) were

2014 Revista brasileira de terapia intensiva Controlled trial quality: uncertain

56. Comparison of methods for evaluation of the suppressive effects of prednisolone on the HPA axis and bone turnover: changes in s-DHEAS are as sensitive as the ACTH test. (Abstract)

. Adrenocorticotrophic hormone (ACTH) stimulation tests and the metyrapone test were also performed. Furthermore, we analyzed levels of serum dehydroepiandrosterone sulfate (s-DHEAS), insulin, and markers of bone turnover.Dose-related effects were shown, but the magnitude of effects and sensitivities varied greatly between the tests. P-cortisol measurements over the course of 24 hours were used as the reference method. Low- and standard-dose ACTH tests and morning s-DHEAS levels had similar sensitivity. Urinary (...) cortisol excretion and the metyrapone stimulation test had low sensitivity. The effects of prednisolone on markers of bone turnover were, in general, less than those on the HPA axis. Only osteocalcin, procollagen Type 1 C-peptide and procollagen Type 3 N-peptide were significantly affected. Treatment with prednisolone was well tolerated.Changes in s-DHEAS and the low-dose ACTH test combine good sensitivity and precision for evaluation of the suppressive effect of exogenous corticosteroids on the HPA

2014 International journal of clinical pharmacology and therapeutics Controlled trial quality: uncertain

57. A Search for Variables Predicting Cortisol Response to Low-Dose Corticotropin Stimulation Following Supraphysiological Doses of Glucocorticoids. (Abstract)

A Search for Variables Predicting Cortisol Response to Low-Dose Corticotropin Stimulation Following Supraphysiological Doses of Glucocorticoids. To determine which biological or clinical variables may predict cortisol response to low-dose adrenocorticotropic hormone (ACTH) stimulation following supraphysiological doses of glucocorticoids in children.This retrospective study included all patients who underwent ACTH testing (1 μg) between October 2008 and June 2010 at the Sainte-Justine (...) (median, 374 days; range, 5-4226 days); duration of physiological hydrocortisone replacement (median, 118 days; range, 0-1089 days); maximum daily (median, 200 mg/m(2)/day; range, 12-3750 mg/m(2)/day) and cumulative (median, 16 728 mg/m(2); range, 82-178 209 mg/m(2)) doses, in hydrocortisone equivalents; and interval since the last dose (median, 43 days; range, 1-1584 days). Sixty-two patients (58%) exhibited a normal response (ie, peak cortisol >500 nmol/L) to ACTH stimulation. Peak cortisol level

2013 Journal of Pediatrics

58. Liquid Chromatography-Tandem Mass Spectrometry Analysis of Human Adrenal Vein 19-Carbon Steroids Before and After ACTH Stimulation. Full Text available with Trip Pro

Liquid Chromatography-Tandem Mass Spectrometry Analysis of Human Adrenal Vein 19-Carbon Steroids Before and After ACTH Stimulation. A broad analysis of adrenal gland-derived 19-carbon (C19) steroids has not been reported. This is the first study that uses liquid chromatography-tandem mass spectrometry to quantify 9 C19 steroids (androgens and their precursors), estrone, and estradiol in the adrenal vein (AV) of women, before and after ACTH stimulation.The objective of this study was to define (...) the adrenal androgen metabolome in women before and after ACTH infusion.This was a retrospective study.Seven women, aged 50.4 ± 5.4 years, with suspected diagnosis of an adrenal aldosterone-producing adenoma were included in the study.AV and iliac serum samples were collected before and after administration of ACTH (15 minutes). AV samples were analyzed using for concentrations of 9 unconjugated C19 steroids, estrone, and estradiol. Dehydroepiandrosterone sulfate (DHEA-S) was quantified

2013 Journal of Clinical Endocrinology and Metabolism

59. Serotonin transporter genotype modulates HPA axis output during stress: effect of stress, dexamethasone test and ACTH challenge Full Text available with Trip Pro

of the central or peripheral nervous system at which the 5HTT genotype acts to modulate the cortisol response.This study assesses a relatively large number of subjects homozygous and heterozygous for the rh5HTT short and long alleles (a) during stress; (b) following a dexamethasone suppression test; and (c) following an adrenocorticotropic hormone (ACTH) challenge. Subjects included 190 infant rhesus macaques (Macaca mulatta - 84 males and 106 females; 118 LL, 60 Ls, and 12 ss subjects), obtaining two blood (...) alleles. Subsequent analyses showed a high correlation between individual cortisol levels across the three different tests.These data suggest that subjects homozygous for the short allele are more likely to show dysregulated cortisol levels in response to stress. Given the correlation in individual responses of the HPA axis across the different tests, our data suggest that the effect of the 5HTT genotype shows some commonality in its regulation of stress, feedback, and ACTH-stimulated cortisol output

2013 Translational developmental psychiatry

60. Evaluation of the (1–24) adrenocorticotropin stimulation test for the diagnosis of primary aldosteronism Full Text available with Trip Pro

Evaluation of the (1–24) adrenocorticotropin stimulation test for the diagnosis of primary aldosteronism The purpose of this study was to investigate the diagnostic power of the adrenocorticotropin (ACTH) stimulation test in patients with primary aldosteronism (PA) and those with aldosterone-producing adenoma (APA).This study was based on a retrospective database analysis.We assessed 158 hypertensive patients with a high plasma aldosterone-to-renin ratio (ARR) including 97 with at least one (...) positive confirmatory test result who did not undergo surgery and comprised a "possible PA" group, 19 with negative results in all tests who were the "non-PA" group, and 41 diagnosed with APA following surgery who were the APA group. The "confirmed PA group" included APA patients and patients from the possible PA group showing both high ARR and hypokalemia. One case was diagnosed as a metastasis.Receiver-operating characteristic (ROC) analysis showed that the diagnostic accuracy of ACTH test

2016 Journal of the Renin-Angiotensin-Aldosterone System: JRAAS

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