Stimulation test adrenocorticotropic hormone

Adrenal angiography Adrenal venography Adrenocorticotropic hormone stimulation test Aldosterone assay, blood Androstenedione Antidiuretic hormone Antithyroglobulin antibody Antithyroid microsomal antibody Blood glucose Calcitonin Calcium Catecholamines Chromosome karyotype Computed tomography of adrenals Cortisol blood urine C-peptide... 

Acetylcholine receptor antibody Acid phosphatase Activated clotting time (ACT) Adrenocorticotropic hormone stimulation test Agglutinins, febrile/cold AIDS serology Alanine aminotransferase Aldolase... 

Stress-induced adrenal insufficiency complicates 9% to 24% of septic patients and is associated with increased mortality. Adrenal-insuffident patients are identified by a adrenocorticotropic hormone (ACTH) stimulation test. Patients are given 250 meg ACTH and a cortisol level is checked within 30 to 60 minutes. Responders are defined as a greater than 9-mcg/dL increase in cortisol and non-responders as a less than 9-mcg/dL increase in cortisol. Septic shock patients refractory to resuscitation and vasopressors, and with adrenal insufifidency (non-responders to the ACTH test) should be administered intravenous hydrocortisone 200 to 300 mg per day in three divided doses for 7 days.24,44... 

BOX SI-2 Protocol for the Multiple-Day Adrenocorticotropic Hormone (ACTH) Stimulation Test... 

The drug is a purely synthetic compound which possesses a distinct unique characteristic feature of inhibiting 11 -P-hydroxylation in the biosynthesis of cortisol, corticosterone and aldosterone. Therefore, it is invariably employed to test for hypothalamic-pituitary function. However, in the normal individual, the drug essentially blocks the specific enzymatic step that ultimately leads to the synthesis of cortisol and corticosterone in vivo), causing an absolute intense stimulation of adrenocorticotropic hormone (ACTH) secretion and inducing thereby a marked and pronounced enhancement in the urinary excretion of 17-hydroxy-corticosteroids. 

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