Long acting porcine sequence ACTH in the diagnosis of adrenal insufficiency
Autor: | Geena Susan George, Chellamma Jayakumari, Abilash Nair, Darvin V Das, Puthiyaveettil Khadar Jabbar, T S Aneesh, S J Jessy |
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Rok vydání: | 2019 |
Předmět: |
Adult
medicine.medical_specialty Hydrocortisone Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Stimulation Young Adult 03 medical and health sciences 0302 clinical medicine Endocrinology Adrenocorticotropic Hormone Internal medicine medicine Adrenal insufficiency Humans Short synacthen test medicine.diagnostic_test business.industry ACTH stimulation test Area under the curve Mean age General Medicine Middle Aged medicine.disease Long acting 030220 oncology & carcinogenesis Cosyntropin business Serum cortisol Adrenal Insufficiency |
Zdroj: | European Journal of Endocrinology. 181:639-645 |
ISSN: | 1479-683X 0804-4643 |
Popis: | Objectives Injectable tetracosactide hexa-acetate, ACTH 1-24 (Synacthen), is not marketed in many countries including India, whereas Injectable long acting porcine sequence, ACTH 1-39 (Acton Prolongatum®) is easily available and much cheaper. This study aimed to find the diagnostic accuracy of ACTH stimulation test using i.m. Acton Prolongatum® (acton prolongatum stimulation test, APST) in comparison with Synacthen (short synacthen test, SST) for the diagnosis of glucocorticoid insufficiency. Methods Subjects with a suspicion of adrenal insufficiency based on clinical features underwent a SST with 250 µg Synacthen followed by APST using 30 units of Acton Prolongatum®. Serum cortisol levels were measured at 60 and 120 min following injection of Acton Prolongatum®. Stimulated peak cortisol of less than 18 µg/dL on SST was considered as adrenal insufficiency. Results Forty seven patients with mean age of 36.7 ± 14.4 years were enrolled for the study. Based on SST, twenty (n = 20) persons were classified as having adrenal insufficiency, whereas twenty-seven (n = 27) were found to be normal. Area under the curve of APST (at 120 min) was 0.986 when compared to SST, thus proving its high accuracy. A serum cortisol cut off value of 19.5 µg/dL at 120-min following stimulation with Acton Prolongatum® showed a sensitivity of 100% and specificity of 88%. Conclusion ACTH stimulation test using Acton Prolongatum® is an economical and accurate alternative to the short Synacthen test. |
Databáze: | OpenAIRE |
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