Morning cortisol as an alternative to Short Synecthan test for the diagnosis of primary adrenal insufficiency

Diagnosis of primary adrenal insufficiency

  • Imran Ulhaq Aga Khan University Hospital
  • Tauseef Ahmad
  • Adeel Khoja
  • Najmul Islam
Keywords: Morning cortisol, Primary adrenal insufficiency, Short synacthan test, Single center

Abstract

Objective: To determine 7-9 am serum cortisol less than 5mcg/dl is an independent reliable confirmatory test for the diagnosis of primary adrenal insufficiency (PAI).

Methods: A total of 164 patients who visited the outpatient or inpatient department of Aga Khan University Hospital from June 2011 to June 2017 were included for the study. All those patients whose levels came out less than 5mcg/dl were recruited for the study and they all underwent SST. Other demographic and laboratory data were also recorded.

Results: The sensitivity of morning cortisol for diagnosis of PAI is 100% if levels are <1mcg/dl and decreases to 71.88% if levels are up to 5mcg/dl.

Conclusion: Morning cortisol is sensitive enough as an alternative to SST if levels are <1mcg/dl (100%). However, if the levels are increased from >1mcg/dl to <5 mcg/dl, the sensitivity decreases gradually from 98% to 71%.

doi: https://doi.org/10.12669/pjms.35.5.1208

How to cite this:
Ulhaq I, Ahmad T, Khoja A, Islam N. Morning cortisol as an alternative to Short Synecthan test for the diagnosis of primary adrenal insufficiency. Pak J Med Sci. 2019;35(5):1413-1416. doi: https://doi.org/10.12669/pjms.35.5.1208

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-08-22
Section
Original Articles