Value of the 30-Minute Adrenocorticotropin (ACTH) Test in Demonstrating Hypothalamic-Pituitary-Adrenocortical Insufficiency after Acute ACTH Deprivation

Abstract
Adrenocortical responsiveness to corticotropin was reestablished by daily administration of 1 mg ACTH depot for 4 days in seven patients with secondary adrenocortical insufficiency. Peak plasma cortisol concentrations during a 30-min ACTH test performed 2 days after stopping injection of ACTH depot increased in all seven subjects (they were normal in five subjects) compared to the initial subnormal responses. Repeated short ACTH tests 5, 8, and 12 days after the last administration of ACTH depot showed a gradual decrease in plasma cortisol responses. When tested 8 days after the last ACTH depot injection was given all seven patients again had a subnormal response to ACTH. Thus, acute ACTH deprivation leads to an impaired adrenocortical response at a short ACTH test within 8–12 days.

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