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Cosyntropin-stimulated salivary cortisol in hospitalized patients with hypoproteinemia. Endocrine 2008 Aug-Dec;34(1-3):68-74

Date

10/24/2008

Pubmed ID

18946745

DOI

10.1007/s12020-008-9101-y

Scopus ID

2-s2.0-65449141396   18 Citations

Abstract

Analysis of adrenocortical function in acutely ill, hospitalized patients can be challenging due to changes in plasma binding proteins. This study used dynamic testing of salivary cortisol levels to evaluate adrenal function in hospitalized patients with low/low-normal plasma protein concentration in whom adrenal insufficiency was suspected. Twenty-eight patients with low serum albumin and proteins hospitalized for acute illness were evaluated for decreased adrenocortical function because of clinical presentations suspicious for adrenal insufficiency. Baseline and post cosyntropin-stimulated levels of serum total and salivary cortisol levels were assessed. Data were gathered by a retrospective analysis of medical records. Eight patients had normal peak serum total and salivary cortisol responses, consistent with intact adrenocortical function. Five patients had abnormal peak serum total and salivary cortisol responses indicating decreased adrenocortical function. Fifteen patients had subnormal peak serum total cortisol, but normal peak salivary cortisol responses indicating normal adrenal function. Salivary cortisol testing can identify hospitalized patients with apparently intact adrenal function in whom low serum protein confounded interpretation of serum total cortisol measurements. Salivary cortisol is a clinically useful surrogate for serum free cortisol in dynamic testing of adrenocortical function.

Author List

Raff H, Brock S, Findling JW

Authors

James W. Findling MD Staff Physician in the Multi-Specialty department at Medical College of Wisconsin
Hershel Raff PhD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adrenal Insufficiency
Adult
Aged
Aged, 80 and over
Cosyntropin
Critical Illness
Female
Hospitalization
Humans
Hydrocortisone
Hypoproteinemia
Inpatients
Male
Middle Aged
Pituitary-Adrenal Function Tests
Reproducibility of Results
Retrospective Studies
Saliva
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d