Measurement of the adrenal cortex reserve using depot beta 1-24-corticotrophin. I--In adrenal insufficiency.

Abstract

Adrenal reserve was assessed by measuring plasma cortisol 4 and 6 hours after instramuscular injection of 1 mg Synacthen Depot in 87 normal subjects (95 tests), in 13 patients with primary adrenal insufficiency (26 tests) and in 21 patients with secondary adrenal insufficiency (30 tests). Wjth this Synacthen Depot test differenciation between normals (plasma cortisol 4-6 hours after Synacthen Depot 62.9 ± 12.26 μg/100 mg) and adrenal insufficiency, either primary (9.8}3.67 μg/100 ml) or secondary (21.3}12.65 μg/100 ml) was possible in all cases (p less than 0.001). On the contrary in some patients with secondary hypoadrenalism a single injection of Synacthen Depot did not secure their differentiation from patients with primary hypoadrenalism and further injections were required to establish the diagnosis