Endocrine Abstracts

Background: Short synacthen(cosyntropin)test, has replaced the insulin stress test as the first-line test to assess adrenal insufficiency. The aim of this study, was to determine the utility of the 30 and 60 min cortisol measurement in the high dose (250 μg) short synacthen test.

Methods: Cross sectional study was conducted by reviewing the database of patients underwent short synacthen test in Al-Faiha Diabetes Endocrine and Metabolism Center (FDEMC) for the peroid from November 2009 to May 2013.

Results: Study participants includes 435 patients. The cortisol response in short synacthen test was sufficient in 198 (45.5%) patients, and abnormal in 237 (54.4%) patients. It was insufficient at 30 min only in 56 (12.9%) patients, insufficient at 60 min only in 5 (1.1%) patients and insufficient at both 30 and 60 min in 176 (40.5%) patients. Insufficient at 30 min and sufficient at 60 min was seen in 120 (27.6%) patients. This means that the false negative test if the 60 min sample was not taken was 27.6%. Only 5 (1.1%) patients with normal response at 30 min will regress to response at 60 min.

Conclusion: Measuring both 30 and 60 min cortisol level are necessary and at 60 min is fundamental in interpretation of short synacthen test.