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Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency


Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency



Clinical Endocrinology 26(2): 221-226



ISSN/ISBN: 0300-0664

PMID: 3311477

DOI: 10.1111/j.1365-2265.1987.tb00780.x

A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing.

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Accession: 041935878

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