Diagnostic Utility of Low-Dose Cosyntropin Stimulation Test for Central Adrenal Insufficiency
Authors' conclusion
The strong correlation between cortisol responses in the LDT and HDT suggests that, when appropriately lower cutoff values are applied, the LDT provides results comparable to the HDT.
Study context
- Population
- Children who underwent sequential LDT and high-dose test (HDT) for prolonged systemic glucocorticoid exposure (group 1) or suspected hypothalamic-pituitary dysfunction (group 2)20 with ACTHD
- Participants
- 112 children
- Comparison
- Low-dose cosyntropin test vs standard high-dose test as reference
- Outcome
- Sensitivity and specificity of LDT cortisol levels for diagnosing adrenocorticotropic hormone (ACTH) deficiency (ACTHD) by ROC analysis against HDT
Methodological detailssequential LDT and HDT
- Sequential LDT and HDT
Performance
As reported in the abstract
Diagnostic accuracy of LDT cortisol peak 13.5 μg/dL (372 nmol/L) for ACTHD, entire cohort
| Test or model | Cutoff | Sensitivity | Specificity | AUC |
|---|---|---|---|---|
| LDT | 13.5 μg/dL (372 nmol/L) | 90% | 90% | 0.973 (95% CI 0.945-1, p < 0.001) |
LDT
Cutoff13.5 μg/dL (372 nmol/L)
Sensitivity90%
Specificity90%
AUC0.973 (95% CI 0.945-1, p < 0.001)
- Correlation between peak cortisol in LDT and HDT
- r = 0.93, p < 0.001
Further findings
LDT cortisol cutoff for comparable performance by subgroup
- Higher cortisol cutoff needed for group 1 (glucocorticoid exposure) than group 2 (suspected hypothalamic-pituitary dysfunction)
- 14.5 vs. 11.5 μg/dL [317 nmol/L]
Original publication
Diagnostic Utility of Low-Dose Cosyntropin Stimulation Test for Central Adrenal Insufficiency. Horm Res Paediatr. Published 6 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →