IMPROVED SINGLE-DOSE METYRAPONE TEST

  • 1 January 1980
    • journal article
    • research article
    • Vol. 16  (5) , 365-369
Abstract
One dose of metyrapone (1.5 g) administered at 0600 h with subsequent measurement of plasma ACTH, 11-deoxycortisol, or 17-hydroxycorticosteroids (17-OHCS) (cortisol + 11-deoxycortisol) at 1200 and 1400 h allowed an accurate assessment of the pituitary-adrenal reserve. Eighteen subjects with a normal pituitary-adrenal reserve were studied before and after the administration of this single metyrapone dose. By 1200 h plasma ACTH rose from a premedication value of 39 .+-. 22 (SD) to 193 .+-. 104 pg/ml and 11-deoxycortisol, from 0.3 .+-. 0.3 (SD) to 9.0 .+-. 2.7 .mu.g/dl. By 1400 h, plasma 17-OHCS had increased from a premedication value of 5.0 .+-. 1.5 (SD) to 16.0 .+-. 1.8 .mu.g/dl. The differences between pre- and postmedication values were statistically significant for all indices measured (P < 0.001). No overlap was found between values before and after metyrapone. This protocol eliminates the need for metyrapone administration every 4 h over a 24 h period. It offers the advantage of low dose and low toxicity. The integrity of the pituitary-adrenal axis can be demonstrated by measuring either plasma ACTH and 11-deoxycortisol or even 17-OHCS 6 to 8 h after the administration of this single metyrapone dose.

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