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AN ASSESSMENT OF THE METYRAPONE TEST
Author(s) -
SHAHMANESH M.,
HARTOG M.,
CROOK D.
Publication year - 1973
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1973.tb00420.x
Subject(s) - metyrapone , endocrinology , medicine , basal (medicine) , urinary system , enzyme inhibition , adrenal adenoma , cushing syndrome , enzyme , adenoma , chemistry , biochemistry , insulin
SUMMARY The degree of 11β‐hydroxylase inhibition produced during a 24 hr metyrapone test was assessed in sixteen normal subjects and seven patients with Cushing's syndrome using a urinary GLC method which distinguishes between 11‐deoxy‐corticosteroids and 11‐oxygenated corticosteroids. A doubling over basal values and a rise of total urinary corticosteroids of more than 10 mg in 24 hr was seen in all the fifteen normal subjects who achieved over 70% enzyme inhibition in at least one 24 hr period after the administration of metyrapone. All patients with Cushing's syndrome showed over 70% enzyme inhibition. On the basis of the test it was possible to distinguish between pituitary dependent Cushing's syndrome and that caused by an adrenal adenoma. A single patient with the ectopic ACTH syndrome showed a normal metyrapone response. The urinary GLC method provides a simple means of assessing the adequacy of enzyme inhibition produced by metyrapone.