Open AccessLow dose adrenocorticotropic hormone test and adrenal insufficiency in critically ill acquired immunodeficiency syndrome patients
Author(s) -
Shashidhar Pk,
Shashikala Gv
Publication year - 2012
Publication title -
indian journal of endocrinology and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 28
eISSN - 2230-9500
pISSN - 2230-8210
DOI - 10.4103/2230-8210.95680
Subject(s) - medicine , adrenal insufficiency , adrenocorticotropic hormone , critically ill , pediatrics , intensive care medicine , hormone
Prevalence of adrenal insufficiency (AI) is not uncommon in HIV infected population. However, AI is rarely diagnosed in clinical practice because many patients have non-specific symptoms and signs. Critical illness in such patients further complicates the evaluation of adrenal function. A 1μgm ACTH test can be used for diagnosis, since it results in more physiological levels of ACTH. A serum cortisol of <18 μg/dL, 30 or 60-minutes after ACTH test has been accepted as indicative of AI, but many experts advocate the normal cortisol response should exceed 25 μg/dL, in critically ill patients.