English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Background:There is no single test can identify hypothalamic-pituitary-adrenal dysfunction (HPAD) perfectly. The study aimed to assess the performance of measuring serum cortisol, serum dehydroepiandrosterone sulfate (DHEA-S) and plasma corticotropin (ACTH) in comparison with standard-dose short cosyntropin (250 µg) testing for the diagnosis of HPAD.Methods:This is a cross-sectional study from Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basrah. For all patients with suspected HAD; baseline serum cortisol, serum dehydroepiandrosterone sulfate (DHEA-S) and plasma corticotropin (ACTH) and were measured, followed by a formal short cosyntropin test as the gold standard test.Results:The total number of the study participant was 169 patients. Of them, 134 (79.3%) were women. Their age ranges from 5-80 years. The cutoff serum cortisol that predicts abnormal short cosyntropin test was less than 5.31µg/dl with maximal sensitivity and specificity of 90.4 % and 92.3% respectively. The cutoff serum DHEA-S that predict abnormal short cosyntropin test was less than 31.11 µg/dl with a sensitivity of 89.2%and specificity of 62.7%.The least reliable parameter to predict the abnormal short cosyntropin was the plasma ACTH  level with a cutoff of less than 5.30 pg/ml and lowest sensitivity of 89.2% and specificity of 62.7%.Conclusion:To exclude HPAD, serum cortisol at 9-11 am having the highest predictive value, DHEA-S has the midway function and plasma ACTH is the least reliable for that.  Combination of serum cortisol and serum DHEA-S yield the best performance for combinations of test. Keywords: Hypothalamic pituitaryadrenal dysfunction, short  cosyntropin test, dehydroepiandrosterone sulfate, corticotropin,cortisol.

international archives of medicine

The performance of serum cortisol, plasma corticotropin and serum dehydroepiandrosterone sulfate levels in the diagnosis of hypothalamic pituitary adrenal dysfunction