dc.creator | Vaiani, Elisa | |
dc.creator | Lazzati, Juan Manuel | |
dc.creator | Ramirez, Pablo | |
dc.creator | Costanzo, Mariana | |
dc.creator | Gil, Silvia | |
dc.creator | Dratler, Gustavo | |
dc.creator | Zaidman, Verónica | |
dc.creator | Chaler, Eduardo Adrian | |
dc.creator | Belgorosky, Alicia | |
dc.date.accessioned | 2021-02-02T12:21:54Z | |
dc.date.accessioned | 2022-10-15T03:11:13Z | |
dc.date.available | 2021-02-02T12:21:54Z | |
dc.date.available | 2022-10-15T03:11:13Z | |
dc.date.created | 2021-02-02T12:21:54Z | |
dc.date.issued | 2019-10 | |
dc.identifier | Vaiani, Elisa; Lazzati, Juan Manuel; Ramirez, Pablo; Costanzo, Mariana; Gil, Silvia; et al.; The Low-Dose ACTH Test: Usefulness of Combined Analysis of Serum and Salivary Maximum Cortisol Response in Pediatrics; Endocrine Society; Journal of Clinical Endocrinology and Metabolism; 104; 10; 10-2019; 4323-4330 | |
dc.identifier | 0021-972X | |
dc.identifier | http://hdl.handle.net/11336/124448 | |
dc.identifier | CONICET Digital | |
dc.identifier | CONICET | |
dc.identifier.uri | https://repositorioslatinoamericanos.uchile.cl/handle/2250/4338627 | |
dc.description.abstract | Context: The low-dose (1 μg) ACTH test (LDT) is widely used to assess central adrenal insufficiency (CAI); however, the serum cortisol cutoff value is controversial. Salivary cortisol (SC) may be a more accurate measurement for CAI. Objective: To assess a new maximum cutoff value of serum cortisol after LDT in pediatric patients, taking into account serum and SC measurements. Design and Setting: Prospective study in a pediatric tertiary referral center. Working Hypothesis: The combined analysis of serum and SC response to LDT might improve LDT for CAI diagnosis. Participant and Outcome Measurement: A total of 145 pediatric patients underwent LDT. Serum and SC levels were measured. A central adrenal sufficient (CAS) response was established according to the reference serum cortisol cutoff value of ≥497 nmol/L. Results: The LDT study showed central adrenal sufficiency in 72 patients and CAI in 73 patients. Considering the lower quartile of maximum SC value (21 nmol/L) in the CAS group, an intermediate CAI (InCAI) group and a real CAI (RCAI) group were defined. Regarding the median maximum value of serum cortisol levels in the InCAI group, a new serum cortisol cutoff value of 450 nmol/L was established. Furthermore, 91% of the patients in the RCAI group were below this cutoff value. Conclusion: The combined evaluation of maximum serum and SC levels to LDT might be useful to define an InCAI group and to avoid unnecessary hormone replacement therapy. However, rigorous patient follow-up is required © 2019 | |
dc.language | eng | |
dc.publisher | Endocrine Society | |
dc.relation | info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/jcem/advance-article/doi/10.1210/jc.2019-00304/5498441 | |
dc.relation | info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1210/jc.2019-00304 | |
dc.rights | https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | Adrenal insufficiency | |
dc.subject | ACTH | |
dc.subject | CORTISOL | |
dc.subject | LDT | |
dc.title | The Low-Dose ACTH Test: Usefulness of Combined Analysis of Serum and Salivary Maximum Cortisol Response in Pediatrics | |
dc.type | info:eu-repo/semantics/article | |
dc.type | info:ar-repo/semantics/artículo | |
dc.type | info:eu-repo/semantics/publishedVersion | |