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A New Approach - Home Waking Salivary Cortisone to Screen for Adrenal Insufficiency. NEJM Evid 2023 Feb;2(2):EVIDe2200306

Date

02/06/2024

Pubmed ID

38320042

DOI

10.1056/EVIDe2200306

Abstract

Adrenal insufficiency is a common and potentially life-threatening endocrine disorder that can be drug induced or endogenous and of adrenal (primary) or pituitary/hypothalamic (secondary/tertiary) origin.1,2 Of particular concern in drug-induced disease is the patient with glucocorticoid- or opioid-induced adrenal insufficiency. Adrenal insufficiency of any cause is typically diagnosed biochemically with a subnormal morning serum cortisol (the circadian, awakening peak) and serum dehydroepiandrosterone sulfate, followed by or simultaneously with an assessment of the acute (30 and 60 minutes) serum cortisol response to injected synthetic corticotropin (ACTH[1-24]), if clinically indicated.

Author List

Raff H, Zhang CD

Authors

Hershel Raff PhD Professor in the Academic Affairs department at Medical College of Wisconsin
Catherine Zhang MD Assistant Professor in the Medicine department at Medical College of Wisconsin




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

Adrenal Insufficiency
Adrenocorticotropic Hormone
Cortisone
Glucocorticoids
Humans
Hydrocortisone