Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1973 Apr 21;2(5859):147–149. doi: 10.1136/bmj.2.5859.147

Value of an ACTH Test in Assessing Hypothalamic-Pituitary-Adrenocortical Function in Glucocorticoid-treated Patients

Henrik Kehlet, Christian Binder
PMCID: PMC1589254  PMID: 4349334

Abstract

Forty-eight patients receiving glucocorticoid treatment were tested with ACTH stimulation using α1, 24 ACTH (tetracosactrin). All patients subsequently underwent non-acute major surgery without any glucocorticoid administration, and their clinical course and plasma corticosteroids were followed closely. No case of adrenocortical insufficiency was observed. A highly significant correlation was found between the pre-operative adrenocortical response to ACTH and the hypothalmic-pituitary-adrenocortical (H.P.A.) response to surgery. A normal response to ACTH stimulation was never followed by a greatly impaired H.P.A. response to surgery. It seems that a simple ACTH stimulation test is reliable in predicting the integrated H.P.A. response to major stress in glucocorticoid-treated patients.

Full text

PDF
147

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRINCK-JOHNSEN T., SOLEM J. H., BRINCK-JOHNSEN K., INGVALDSEN P. The 17-hydroxycorticosteroid response to corticotrophin, metopiron and bacterial pyrogen. Acta Med Scand. 1963 Feb;173:129–140. doi: 10.1111/j.0954-6820.1963.tb16514.x. [DOI] [PubMed] [Google Scholar]
  2. Binder C. Interdaily variation in plasma concentration of 11-hydroxycorticosteroids. Acta Endocrinol (Copenh) 1972 Feb;69(2):355–358. doi: 10.1530/acta.0.0690355. [DOI] [PubMed] [Google Scholar]
  3. ENGEL E., DEMANET J. C., BRICHANT J., RIONDEL A. M. Emploi d'un pyrogène comme test de la stimulation neuro-hypophyso-surrénalienne. Helv Med Acta. 1958 Oct;25(4):552–557. [PubMed] [Google Scholar]
  4. GRABER A. L., NEY R. L., NICHOLSON W. E., ISLAND D. P., LIDDLE G. W. NATURAL HISTORY OF PITUITARY-ADRENAL RECOVERY FOLLOWING LONG-TERM SUPPRESSION WITH CORTICOSTEROIDS. J Clin Endocrinol Metab. 1965 Jan;25:11–16. doi: 10.1210/jcem-25-1-11. [DOI] [PubMed] [Google Scholar]
  5. HOLUB D. A., JAILER J. W., KITAY J. I., FRANTZ A. G. Direct and indirect estimation of pituitary adrenocorticotropin reserves in man following adrenal steroid therapy. J Clin Endocrinol Metab. 1959 Dec;19:1540–1552. doi: 10.1210/jcem-19-12-1540. [DOI] [PubMed] [Google Scholar]
  6. LI C. H. Proposed system of terminology for preparations of adrenocorticotropic hormone. Science. 1959 Apr 10;129(3354):969–970. doi: 10.1126/science.129.3354.969-a. [DOI] [PubMed] [Google Scholar]
  7. Plumpton F. S., Besser G. M., Cole P. V. Corticosteroid treatment and surgery. 1. An investigation of the indications for steroid cover. Anaesthesia. 1969 Jan;24(1):3–11. doi: 10.1111/j.1365-2044.1969.tb02798.x. [DOI] [PubMed] [Google Scholar]
  8. ROBINSON B. H., MATTINGLY D., COPE C. L. Adrenal function after prolonged corticosteroid therapy. Br Med J. 1962 Jun 9;1(5292):1579–1584. doi: 10.1136/bmj.1.5292.1579. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. TREADWELL B. L., SALVAGE O., SEVER E. D., COPEMAN W. S. Pituitary-adrenal function during corticosteroid therapy. Lancet. 1963 Feb 16;1(7277):355–358. doi: 10.1016/s0140-6736(63)91383-7. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES