ACTH stimulation testing

The adequacy of the adrenal response to ACTH was tested directly by treated with exogenous ACTH and measuring the resulting changes in urinary cortisol metabolite levels. Measurements in timed urine collections provide an overall indicator of the output of glucocorticoids.

ACTH was given as an iv infusion on each of 2 sequential days; cortisol metabolites (17-OH-corticosteroids and 17-ketosteroids) were measured in 24-hour urine collections before ACTH was given, during the days ACTH was infused, and on the day after the last ACTH infusion.

24-hr urine:          17-OH-Corticosteroids     17-Ketosteroids      Aldosterone
Day 1, baseline               2.2 mg                 3.8 mg             2.3 mg
Day 2, baseline               2.1                    4.0                2.4
Day 3, ACTH                   2.0                    5.0                2.6
Day 4, ACTH                   1.9                    4.0                2.5
Day 5, post-ACTH              0.8                    3.6                1.8

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