- Published on
Diagnostic Tests – ACTH (Cosyntropin) Stimulation Test
1. What is this test?
The ACTH (cosyntropin) stimulation test is a diagnostic evaluation of adrenal gland function. It is considered the gold-standard test for identifying adrenal insufficiency. The test begins with measurement of baseline serum cortisol levels. Synthetic ACTH (cosyntropin) is then administered, followed by repeat cortisol measurements at specified intervals. An inadequate cortisol response suggests adrenal insufficiency. Persistently low cortisol levels point toward primary adrenal insufficiency, whereas an appropriate rise in cortisol indicates that the adrenal glands are capable of responding to ACTH stimulation.
2. When should you order or interpret an ACTH stimulation test?
This test should be considered in patients with clinical features suggestive of adrenal insufficiency. Classic findings include chronic fatigue, generalized weakness, skin hyperpigmentation, hyperkalemia, mild metabolic acidosis, and salt craving (often described as a preference for salty foods such as pickle juice). It is also particularly important in critically ill or ICU patients who present with unexplained hypotension that does not respond adequately to fluids or vasopressors, where occult adrenal insufficiency may be life-threatening.
1. What is this test?
The ACTH (cosyntropin) stimulation test is a diagnostic evaluation of adrenal gland function. It is considered the gold-standard test for identifying adrenal insufficiency. The test begins with measurement of baseline serum cortisol levels. Synthetic ACTH (cosyntropin) is then administered, followed by repeat cortisol measurements at specified intervals. An inadequate cortisol response suggests adrenal insufficiency. Persistently low cortisol levels point toward primary adrenal insufficiency, whereas an appropriate rise in cortisol indicates that the adrenal glands are capable of responding to ACTH stimulation.
2. When should you order or interpret an ACTH stimulation test?
This test should be considered in patients with clinical features suggestive of adrenal insufficiency. Classic findings include chronic fatigue, generalized weakness, skin hyperpigmentation, hyperkalemia, mild metabolic acidosis, and salt craving (often described as a preference for salty foods such as pickle juice). It is also particularly important in critically ill or ICU patients who present with unexplained hypotension that does not respond adequately to fluids or vasopressors, where occult adrenal insufficiency may be life-threatening.
0 Comments
