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Comparison of one week 0900 h serum cortisol, low and standard dose Synacthen tests with a 4 to 6 week insulin hypoglycaemia test after pituitary surgery in assessing HPA axis by C. H. Courtney; A. S. McAllister; D. R. McCance; P. M. Bell; D. R. Hadden; H. Leslie; B. Sheridan; A. B. Atkinson is a Medicine article available to read on EtoBox.

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## OBJECTIVE To compare the use of 0900 h serum cortisol and both low and standard dose Synacthen tests, one week after pituitary surgery with an insulin hypoglycaemia test performed 4–6 weeks after surgery in assessing the integrity of the hypothalamic–pituitary–adrenal (HPA) axis. ## DESIGN 0900 h basal serum cortisol was measured on days 6 and 7 after pituitary surgery (24 h off replacement hydrocortisone) followed by a low dose Synacthen test (1 μg intravenously) on day 6 and a standard dose Synacthen test (250 μg intramuscularly) on day 7. Three to 5 weeks later an insulin hypoglycaemia test was performed on all patients. Both low and standard dose Synacthen tests were performed on control subjects using an identical protocol. ## SUBJECTS Forty‐two patients (21 male, 21 female), median age 49 years (range 23–73) who had pituitary surgery (Cushing's disease excluded). One patient had undergone repeat surgery for residual tumour and was studied following each operation. Sixteen healthy normal volunteers, median age 37 years (range 21–55). ## MEASUREMENTS Serum cortisol measured by radioimmunoassay. ## RESULTS Two standard deviations below the mean serum cortisol (logarithmic tra

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Author

C. H. Courtney; A. S. McAllister; D. R. McCance; P. M. Bell; D. R. Hadden; H. Leslie; B. Sheridan; A. B. Atkinson

Publisher

John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley; Research Square (ISSN 0300-0664)

Published

2000

Language

EN

Field

Medicine (Health Sciences)