The diagnosis and investigation of adrenal insufficiency in adults

This version was published on 1 September 2009

Ann Clin Biochem 2009;46:351-367
doi:10.1258/acb.2009.009101
© 2009 Association for Clinical Biochemistry

 

This Article

Figures Only

Full Text

Full Text (PDF)


All Versions of this Article:

acb.2009.009101v1

46/5/351

most recent


Alert me when this article is cited

Alert me if a correction is posted
Services

Email this article to a friend

Similar articles in this journal


Similar articles in PubMed

Alert me to new issues of the journal

Download to citation manager

Citing Articles

Citing Articles via HighWire

Citing Articles via Web of Science (1)

Citing Articles via Google Scholar
Google Scholar

Articles by Wallace, I.

Articles by Lindsay, J.
Search for Related Content
PubMed

PubMed Citation
Social Bookmarking

What’s this?

Review Article


Ian Wallace1,
Sean Cunningham2 and
John Lindsay1


1 Altnagelvin Area Hospital, Western Health & Social Care Trust, Glenshane Road, Londonderry BT47 6SB, UK;
2 St Vincent’s University Hospital, Dublin, Ireland


Corresponding author: Dr John Lindsay, Consultant Physician, Endocrinology & Diabetes, Altnagelvin Area Hospital, Glenshane Road, Londonderry BT47 6SB, UK. Email: john.lindsay{at}westerntrust.hscni.net

There is considerable variation in the methods used to diagnoseand investigate adrenal insufficiency in clinical practice.These include a range of adrenocorticotropin (ACTH) stimulationand other dynamic testing protocols, serum cortisol cut-offvalues for diagnosis and tests used for differential diagnosis.With the introduction of modern cortisol and ACTH assays, theinterpretation of tests used for diagnosis and differentialdiagnosis has become more complex and requires local validation.This review examines the basis of normal hypothalamic–pituitary–adrenalaxis function and adrenal insufficiency states based upon anevidence base accumulated over the past four decades. The roleof the laboratory in the differential diagnosis and interpretationbased upon assay methodology is discussed. The accurate identificationof patients who may benefit from corticosteroid replacementin special settings such as critical illness is challengingand will be explored.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What’s this?






This article has been cited by other articles:



A. A A Ismail
On the diagnosis and investigation of adrenal insufficiency in adults
Ann Clin Biochem,

January 1, 2010;

47(1):

97 – 98.

[Full Text]
[PDF]