Diagnosing adrenal insufficiency in the setting of new assays with increased sensitivity

Cosyntropin or Adrenocorticotropic hormone (ACTH) stimulation testing is the gold standard for diagnosing adrenal insufficiency (AI). Current practice requires measuring cortisol levels at baseline, +30, and + 60 min post-cosyntropin (1 μg) administration. Older polyclonal antibody assays require peak cortisol levels of 18 μg/dL to rule-out AI. In 2019, monoclonal or LCMS/MS assays were introduced offering increased sensitivity, potentially lowering the cut-off value for ruling out AI (14mcd/dL).
Source: Journal of Pediatric Nursing - Category: Nursing Authors: Source Type: research