TY  - JOUR
TI  - Determination of Cortisol Peak Response Time in ACTH Stimulation Test
AB  - Adrenocorticotropic hormone (ACTH) stimulation test is widely used in diagnosis of adrenal insufficiency. Synthetic ACTH analogue has two formulations: Short-acting intravenous or intramuscular form and intramuscular depot form. In the standard ACTHstimulation test protocol, 250μg synthetic ACTH (1-24) is administered intravenously. Blood samples are then taken at 0, 30, 60 and90 minutes for cortisol. We aimed to determine the time of cortisol peak response by evaluating cortisol responses to intramusculardepot ACTH. Seventy patients who underwent ACTH stimulation test between October 2017 and February 2019 in Eskişehir Osmangazi University Endocrinology Department were included to the study. 250 mcg intramuscular depot ACTH was administeredbetween 08.00-09.00 a.m. Blood samples were taken before ACTH administration and at 30, 60, 120, 240 minutes. Cortisol levels18 mcg/dl and above was accepted as normal response. Since 20 mcg / dl and above are accepted as normal response in differentpublications, evaluation was also made on this value. The highest cortisol level was reached in 240 minutes in all patients. If normalcortisol response is accepted as 20 mcg/dl and above, 38 patients reached normal cortisol values at 30th minute, 12 patients at 60thminute, 6 patients at 120th minute. If normal cortisol response is accepted as 18 mcg/dl and above, 38 patients reached normalcortisol values at 30th minute, 10 patients reached normal cortisol values at 60th minute, 2 patients reached 120th minute. In bothgroups, only one patient was able to reach the target cortisol value after prolongation to 240 minutes. We suggest that prolongation ofthe stimulation test with intramuscular depot ACTH up to 120 minutes may prevent patients from being misdiagnosed with adrenalinsufficiency, but prolongation to 240 minutes will not provide additional benefit.
AU  - Yorulmaz, Goknur
AU  - Aydin Buyruk, Betul
AU  - Alagüney, Elif Sevil
AU  - AKALIN, AYSEN
DO  - 10.20515 / otd. 760378
PY  - 2021
JO  - Osmangazi Tıp Dergisi
VL  - 43
IS  - 1
SN  - 1305-4953
SP  - 46
EP  - 49
DB  - TRDizin
UR  - http://search/yayin/detay/409078
ER  -