Did we always search sufficiently for adrenal insufficiency?

Abstract

Background and objectives. A synthetic ACTH stimulation test is a gold standard to detect occult adrenal insufficiently. The advantages of the test are the ability to perform it at any time and well-known normal or pathological levels of cortisol during the test 30 or 60 minutes after the injection of synthetic ACTH. The aim. Of the work was to find out how often ACTH stimulation test was performed at the Kaunas Endocrinology Center in 2014-2017. Material and methods. Medical documentation of 1471 patients (764 - 52% - women, 707 - 48% - males) was performed for 3 main reasons: 1100 -for investigation of importance of DHEAS in males, 220 - for investigation of adrenal function in ENSAT study and 151 patients for the recent study of clinical expressions in the patients with adrenal tumors. Since cortisol is the most important vital hormone of the adrenal glands, we analyzed the conditions under which it was studied. Results. A suppression test of 1 mg of dexamethasone was usually performed. It was followed by small or high dose dexamethasone suppression tests. It was not possible to determine what time of day cortisol was tested. Of 1471 patients no patient could be found who underwent an ACTH stimulation test. [...].