Single Cortisol Screen of Mackenzie et al for Adrenal Insufficiency

Description

Mackenzie et al reported the use of a single cortisol measurement to screen for adrenal insufficiency. This can help to reduce unnecessary cortisol stimulation testing. The authors are from the Royal Infirmary of Edinburgh, the Royal Centre for Defense Medicine and Western General Hospital in the United Kingdom.

Patient selection: suspected adrenal insufficiency

A subnormal stimulated cortisol by the short synacthen test was < 430 nmol/L (Abbott Architect).

Parameters:

(1) time of day

(2) inpatient vs outpatient

(3) serum cortisol concentration in nmol/L

Time of Day	Patient Status	Cut-off for Sensitive Detection of Subnormal Stimulated Cortisol
8 AM to 12 Noon	inpatient	< 275 nmol/L
	outpatient	< 275 nmol/L
12 Noon to 6 PM	inpatient	NA
	outpatient	< 250 nmol/L

Sensitivity at the cut-offs was 96%.

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Single Cortisol Screen of Mackenzie et al for Adrenal Insufficiency

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