In 1968, Migeon et al described 6 patients with a syndrome of adrenal unresponsiveness to ACTH characterized by hypoglycemia, hyperpigmentation, feeding problems in infancy, low urinary 17-hydroxycorticosteroids, an ability to conserve sodium and increase aldosterone secretion in response to salt deprivation, and a lack of elevation of 17-hydroxycorticosteroid secretion or plasma cortisol concentration with ACTH administration. (medscape.com)
4] A progressive deterioration of glucocorticoid function was observed in these patients, which suggested an inherited degenerative process involving the adrenal zona fasciculata and reticularis rather than a primary unresponsiveness to ACTH, as initially proposed. (medscape.com)
After the blood sample is collected, a prophylactic dose of glucocorticoid may be considered for patients with high risk for acute adrenal insufficiency. (nih.gov)
An intact HPA axis function is generally indicated by an increase in 11‑desoxycortisol to over 70 mcg/L. Because of an overlap between a normal ACTH response and an abnormal ACTH response, the ACTH response alone cannot be used to distinguish between healthy individuals and those with adrenal insufficiency. (nih.gov)
ACTH5
The second sister had low levels of plasma 11-hydroxycorticosterone that did not respond to adrenocorticotropic hormone (ACTH). (medscape.com)
In 1972, Kelch et al reported 3 patients with severe isolated glucocorticoid deficiency who did not respond to ACTH stimulation. (medscape.com)
This test, usually given on an outpatient basis, determines plasma 11-desoxycortisol and/or ACTH levels after a single dose of Metopirone. (nih.gov)
Approximately 8 hours after administration of Metopirone, evaluate the values of ACTH and 11-desoxycortisol. (nih.gov)
Normal values will depend on the method used to determine ACTH and 11‑desoxycortisol levels. (nih.gov)
Plasma1
These changes are accompanied by low plasma cortisol concentrations because the zona fasciculata is primarily responsible for glucocorticoid production. (medscape.com)
Normal1
In 1973, Moshang et al studied 5 affected siblings, each of whom demonstrated primary glucocorticoid deficiency and normal mineralocorticoid function. (medscape.com)
Adrenal insufficiency2
After the blood sample is collected, a prophylactic dose of glucocorticoid may be considered for patients with high risk for acute adrenal insufficiency. (nih.gov)
An intact HPA axis function is generally indicated by an increase in 11‑desoxycortisol to over 70 mcg/L. Because of an overlap between a normal ACTH response and an abnormal ACTH response, the ACTH response alone cannot be used to distinguish between healthy individuals and those with adrenal insufficiency. (nih.gov)
Cortisol6
An high-affinity, NAD-dependent 11-beta-hydroxysteroid dehydrogenase that acts unidirectionally to catalyze the dehydrogenation of CORTISOL to CORTISONE. (lookformedical.com)
Beginning with a high clinical suspicion based on discriminatory physical features and/or refractory hypertension, one must initially establish a diagnosis of hypercortisolemia using an 11 p.m. salivary cortisol test. (medscape.com)
[ 41 ] have shown that an 11 p.m. salivary cortisol level is equal in efficacy to midnight salivary cortisol levels in terms of sensitivity and specificity for the diagnosis of Cushing syndrome. (medscape.com)
[ 41 ] Hence, a more convenient "bedtime" 11 p.m. cortisol can be measured. (medscape.com)
Two hundred and sixty- evening (93%) cortisol mean, and the ratio (11%) of morning to three patients were evaluated: 240 had CS, and 23 had PCS. (nih.gov)
The substantial overlap in urinary tients (13%) (11) and in patients with major depression (43%) free cortisol (UFC) excretion and clinical features between or other psychiatric disorders (8 - 41%) (12). (nih.gov)
Concentration2
Glucocorticoids were named for their actions on blood glucose concentration, but they have equally important effects on protein and fat metabolism. (lookformedical.com)
PMID- 5428635 TI - Circadian rhythms in plasma concentration of 11-hydroxycorticosteroids in men working on night shift and in permanent night workers. (nih.gov)
Corticosteroids4
A group of corticosteroids bearing a hydroxy group at the 11-position. (nih.gov)
A glucocorticoid with the general properties of the corticosteroids. (lookformedical.com)
A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. (lookformedical.com)
A glucocorticoid given, as the free alcohol or in esterified form, orally, intramuscularly, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. (lookformedical.com)
Patients1
As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary CUSHING SYNDROME. (lookformedical.com)