Ongoing protocols are designed to: 1) develop a normative range for the free cortisol and aldosterone responses to the 250 mcg Cortrosyn stimulation test in healthy volunteers and compare these responses to those of patients with known primary and secondary adrenal insufficiency 2) evaluate adrenal function in critically ill patients with septic shock using these tests and 3) evaluate the prevalence of adrenal insufficiency in patients receiving intermittent high doses of steroids. For study 3, patients undergoing bone marrow transplantation will undergo the cortrosyn tests as well as an insulin tolerance test at monthly intervals after receiving monthly high-dose glucocorticoids. 4)assess the effect of altered protein status on total and free cortisol levels in the evaluation of adrenal insufficiency in patients with cirrhosis and nephrotic syndrome. The protocols are not fully recruited and no interval information has been published.
|Abraham, Smita Baid; Abel, Brent S; Sinaii, Ninet et al. (2015) Primary vs secondary adrenal insufficiency: ACTH-stimulated aldosterone diagnostic cut-off values by tandem mass spectrometry. Clin Endocrinol (Oxf) 83:308-14|
|Mallappa, Ashwini; Sinaii, Ninet; Kumar, Parag et al. (2015) A phase 2 study of Chronocort, a modified-release formulation of hydrocortisone, in the treatment of adults with classic congenital adrenal hyperplasia. J Clin Endocrinol Metab 100:1137-45|
|Raff, Hershel; Sharma, Susmeeta T; Nieman, Lynnette K (2014) Physiological basis for the etiology, diagnosis, and treatment of adrenal disorders: Cushing's syndrome, adrenal insufficiency, and congenital adrenal hyperplasia. Compr Physiol 4:739-69|
|Cortés-Puch, Irene; Hicks, Caitlin W; Sun, Junfeng et al. (2014) Hypothalamic-pituitary-adrenal axis in lethal canine Staphylococcus aureus pneumonia. Am J Physiol Endocrinol Metab 307:E994-E1008|
|Neary, Nicola; Nieman, Lynnette (2010) Adrenal insufficiency: etiology, diagnosis and treatment. Curr Opin Endocrinol Diabetes Obes 17:217-23|
|Wade, Matthew; Baid, Smita; Calis, Karim et al. (2010) Technical details influence the diagnostic accuracy of the 1 microg ACTH stimulation test. Eur J Endocrinol 162:109-13|