+ Translate
+ Most Popular
Gaucher's disease;thirty-two years experience at Siriraj Hospital
A study of Macrobathra Meyrick from China (Lepidoptera, Cosmopterigidae)
First occurrence in ores of tetragonal chalcocite
Effects of trace element nutrition on sleep patterns in adult women
N.Z. range management guidelines. 2. Design of grazing management systems for tussock country
A case of lipoma of the esophagus
A revision of world Acanthosomatidae (Heteroptera: Pentatomidae): keys to and descriptions of subfamilies, tribes and genera, with designation of types
Life history of the coronate scyphozoan Linuche unguiculata (Swartz, 1788)
Perceptual restoration of obliterated sounds
Mutagenicity studies on two chromium(III) coordination compounds
The formation of the skeleton. I. Growth of a long bone. 1st appearance of a center of calcification
Leucopenia and abnormal liver function in travellers on malaria chemoprophylaxis
The joint commission: four key root causes loom large in sentinel event data
Treatment of vitiligo with topical 15% lactic acid solution in combination with ultra violet-A
Behaviour of dairy cows within three hours after feed supply: I. Influence of housing type and time elapsing after feed supply
Observations of the propagation velocity and formation mechanism of burst fractures caused by gunshot
Management and control of patients with type 2 diabetes mellitus in Lebanon: results from the International Diabetes Management Practices Study (IDMPS)
The diet composition and nutritional knowledge of patients with anorexia nervosa
Physoporella croatica Herak, 1958 of the Slovak karst Anisian (Slovakia, the West Carpathians Mts.)
Bright lights, big noise. How effective are vehicle warning systems?
Ein Plesiosaurier-Rest mit Magensteinen aus mittlerem Lias von Quedlinburg
Incidence of Chlamydia trachomatis in patients with sterility
Monster soup: the microscope and Victorian fantasy
Preliminary tests with residual sprays against poultry lice
Duration of the life of plants in phylogeny

Variability of cortisol assays can confound the diagnosis of adrenal insufficiency in the critically ill population

Variability of cortisol assays can confound the diagnosis of adrenal insufficiency in the critically ill population

Intensive Care Medicine 32(11): 1901-1905

ISSN/ISBN: 0342-4642

PMID: 17019540

DOI: 10.1007/s00134-006-0389-x

To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. Observational interventional in the general intensive care unit of a metropolitan hospital Patients admitted to the intensive care unit with a diagnosis of sepsis and fulfilling criteria of systemic inflammatory response syndrome. Standard short synacthen test performed with 250microg cosyntropin. Two of the three immunoassays returned results significantly higher than those obtained by HPLC: Immulite by 95% (95%CI 31-188%) and TDx by 79% (21-165%). The limits of agreement for all three immunoassays with HPLC ranged from -62% to 770%. In addition, by classifying the patients into responders and non-responders to ACTH by standard criteria there was concordance in all assays in only 44% of patients. Immunoassay estimation of total plasma cortisol in septic patients shows wide assay related variation that may have significant impact in the diagnosis of relative adrenal insufficiency.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 050932124

Download citation: RISBibTeXText

Related references

Variability of cortisol assays can confound the diagnosis of adrenal insufficiency in the critically ill population. Yearbook of Critical Care Medicine 2008: 222-225, 2008

New Cutoffs for the Biochemical Diagnosis of Adrenal Insufficiency after ACTH Stimulation using Specific Cortisol Assays. Journal of the Endocrine Society 5(4): Bvab022, 2021

Minding the gap between cortisol levels measured with second-generation assays and current diagnostic thresholds for the diagnosis of adrenal insufficiency: a single-center experience. Hormones 19(3): 425-431, 2020

Comparison of total cortisol, free cortisol, and surrogate markers of free cortisol in diagnosis of adrenal insufficiency in patients with stable cirrhosis. Clinical Gastroenterology and Hepatology: the Official Clinical Practice Journal of the American Gastroenterological Association 12(3): 504, 2014

Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency. Clinical Endocrinology 26(2): 221-226, 1987

Free cortisol and accuracy of total cortisol measurements in the diagnosis of adrenal insufficiency in brain-dead patients. Anesthesiology 115(3): 568-574, 2011

Performance of salivary cortisol in the diagnosis of Cushing's syndrome, adrenal incidentaloma, and adrenal insufficiency. European Journal of Endocrinology 169(1): 31-36, 2013

Using serum total cortisol assays overstates the adrenal insufficiency prevalence in cirrhotic patients. European Review for Medical and Pharmacological Sciences 20(18): 3730-3731, 2016

Does concomitant autonomous adrenal cortisol overproduction have the potential to confound the interpretation of adrenal venous sampling in primary aldosteronism?. Clinical Endocrinology 83(4): 456-461, 2015

Diagnosis of adrenal cortex insufficiency in steroid-dependent bronchial asthma--the CRH test in comparison with diurnal cortisol profile in serum and cortisol in 24-hour urine. Pneumologie 48(11): 793-798, 1994

Adrenal insufficiency in the critically ill trauma population. The American Surgeon 72(5): 373-376, 2006

Adrenal insufficiency in the critically III trauma population. American Surgeon 72(5): 373-376, 2006

Diagnosis of relative adrenal insufficiency in critically ill patients. Lancet 354(9180): 774-775, 1999

The diagnosis of adrenal insufficiency in the critically ill patient: does it really matter?. Critical Care 10(6): 176, 2006

Diagnosis and treatment of adrenal insufficiency in the critically ill patient. PharmacoTherapy 27(11): 1512-1528, 2007