Research Information System
HORMONE RESEARCH IN PAEDIATRICS, vol.75, no.3, pp.200-205, 2011 (SCI-Expanded)
Background/Aim: It was the aim of this study to evaluate subtle adrenocorticotropic hormone deficiencies in a group of patients with idiopathic growth hormone deficiency and without thyroid-stimulating hormone deficiency. Methods: Growth hormone and cortisol responses to an insulin tolerance test of 25 patients (15 males and 10 females) were evaluated at diagnosis (11.8 +/- 2.5 years) and at the time of retesting (14.6 +/- 1.6 years). A cortisol response < 416,416-555 and > 555 nmol/l was defined as inadequate, blunted and normal, respectively. Results: Baseline cortisol responses to the insulin tolerance test were subnormal in 10 of the 25 patients (6 had blunted responses and 4 had inadequate responses). The mean +/- SD of normal, blunted and inadequate cortisol response at diagnosis was 722.2 +/- 127.8, 480.4 +/- 37.4 and 317.7 +/- 81.7 nmol/l, respectively. Five of these patients showed improved cortisol response at retesting. Three of the 15 patients who had a normal baseline cortisol response developed blunted cortisol response at re-evaluation. The mean +/- SD of normal and blunted plus inadequate cortisol response at retesting was 668.1 +/- 116.1 and 467.3 +/- 64 nmol/l, respectively. All patients with a subnormal cortisol level were asymptomatic. Conclusion: Asymptomatic adrenocorticotropic hormone deficiency patients should be followed up closely, and treatment should be considered in a stress situation after reevaluation of the hypothalamic-pituitary-adrenal axis. Copyright (C) 2010 S. Karger AG, Basel