Abstract
Plasma ACTH (direct radioimmunoassay), cortisol (R.I.A.) and compound S (R.I.A.) were measured during insulin induced hypoglycemia or 3 to 7 h after a single oral dose (1 g/m2) of metyrapone taken at 7 a.m. or at midnight. The mean maximum ACTH concentration after hypoglycemia (316 ± 196 pg/ml) was comparable to the mean maximum 7 h (507 ± 344 pg/ml) and 3 h (416 ± 366 pg/ml) after metyrapone. Compound S rose to 6, 2 ± 3, 9 ng/ml, plasma cortisol was suppressed (6, 2 ± 2, 8 μg%) 3 h after metyrapone and stimulated (17, 4 ± 6, 6 μg%) 7 h after the midnight dose. Within 70 children tested a diminished or absent response was observed in patients under cyproterone acetate after steroid therapy (2), in hypothalamo-pit. insufficiency (4) and anorexia nervosa (1). The single dose metyrapone test is a safe and reliable procedure for the assessment of the hypothalamo-pituitary adrenal system. If the test is based on the compound S and cortisol response alone, it does not require venipuncture.
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Girard, J., Baumann, J. & Staub, J. Plasma ACTH and compound S response to a single oral dose of metgrapone. Pediatr Res 12, 162 (1978). https://doi.org/10.1203/00006450-197802000-00099
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DOI: https://doi.org/10.1203/00006450-197802000-00099