Short synacthen must be performed as soon as possible
(within 72 hours) after starting dexamethasone cover.
In this short period of time, the adrenal cortex, if
normal, should respond adequately to exogenous
synacthen as adrenal atrophy is unlikely to result
from such a short course of steroid. Dexamethasone
therapy can be continued during the test and be safely
discontinued thereafter if the adrenocortical response
is normal.
regards
Mohammad
--- Eric Kilpatrick <[log in to unmask]>
wrote: > There seems variability in clinicians
approach to
> synacthen test requesting and interpretation in
> patients started on dexamethasone following
> suspected Addison's. Some recommend discontinuing
> the dexamethasone for a (variable) period of time
> before doing the test and interpreting normally and
> other suggest continuing and just assessing the
> increment in cortisol post synacthen. Is there any
> official consensus and/or what is the advice given
> elsewhere?
>
> Eric
>
> Dr. Eric S. Kilpatrick
> Consultant in Chemical Pathology
> Hull Royal Infirmary
> Anlaby Rd
> Hull HU3 2JZ
> Tel: 01482-607708
> Fax: 01482-607725
>
=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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