adrenal insufficiency/albumin

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Comparison of total cortisol, free cortisol, and surrogate markers of free cortisol in diagnosis of adrenal insufficiency in patients with stable cirrhosis.

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OBJECTIVE Measurements of serum levels of total cortisol can overestimate the prevalence of adrenal dysfunction in patients with cirrhosis because they have low concentrations of corticosteroid-binding globulin and albumin. We used measurements of serum total cortisol and serum free cortisol after

Primary hypoadrenalism assessed by the 1 microg ACTH test in hospitalized patients with active pulmonary tuberculosis.

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Primary hypoadrenalism, assessed by 250 microg ACTH stimulation, is uncommon in patients with active pulmonary tuberculosis (PTB). Since 1 microg ACTH produces an equivalent +30 min cortisol response to 250 microg in control subjects, the 250 microg dose is supraphysiological and may lack

Relative Adrenal Insufficiency is Associated with the Clinical Outcome in Patients with Stable Decompensated Cirrhosis.

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The clinical impact of relative adrenal insufficiency (AI) on patients with stable decompensated cirrhosis (DeCi) has not been yet elucidated. Explore the association between AI and outcome [death or liver transplantation (LT)] in patients with DeCi. Patients with DeCi presenting no active

Free cortisol and accuracy of total cortisol measurements in the diagnosis of adrenal insufficiency in brain-dead patients.

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BACKGROUND After brain death, adrenal insufficiency (AI) is very common and may be one of the mechanisms that contributes to hemodynamic instability and loss of potential organ donors. However, when diagnosed by total cortisol measurement, critically ill patients may be overdiagnosed as having AI.

Relative adrenal insufficiency: an identifiable entity in nonseptic critically ill patients?

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OBJECTIVE To determine whether relative adrenal insufficiency (RAI) can be identified in nonseptic hypotensive patients in the intensive care unit (ICU). METHODS Retrospective study in a medical-surgical ICU of a university hospital. METHODS One hundred and seventy-two nonseptic ICU patients (51%

Plasma Free Cortisol in States of Normal and Altered Binding Globulins: Implications for Adrenal Insufficiency Diagnosis.

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Accurate diagnosis of adrenal insufficiency is critical because there are risks associated with overdiagnosis and underdiagnosis. Data using liquid chromatography tandem mass spectrometry (LC/MS/MS) free cortisol (FC) assays in states of high or low cortisol-binding globulin (CBG)

Effect of albumin concentration on serum cortisol measured by the Bayer Advia Centaur assay.

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BACKGROUND A poor comparison was seen between the Bayer Advia Centaur and the Roche Elecsys cortisol methods using samples sent to the laboratory for cortisol analysis. They were predominantly from patients attending the Endocrine outpatients clinic or patients in the intensive therapy unit. We

The role of corticosteroid-binding globulin in the evaluation of adrenal insufficiency.

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Cortisol is a hydrophobic molecule that is largely bound to corticosteroid-binding globulin (CBG) in the circulation. In the assessment of adrenal insufficiency, many clinicians measure a total serum cortisol level, which assumes that CBG is present in normal concentrations and with a normal binding

Stimulated Salivary Cortisol as a Noninvasive Diagnostic Tool for Adrenal Insufficiency

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Background: Salivary cortisol is routinely used as a diagnostic test for Cushing syndrome. The diagnostic use of salivary cortisol for adrenal insufficiency (AI), however, is less established. We aimed to investigate the utility of

The diagnosis of adrenal insufficiency in the critically ill patient: does it really matter?

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The definition of what constitutes a 'normal' adrenal response to critical illness is unclear. Consequently, published studies have used a variety of biochemical criteria to define 'adrenal insufficiency'. These criteria have been based on the baseline cortisol level or the increment in cortisol

Relative adrenal insufficiency as a predictor of disease severity, mortality, and beneficial effects of corticosteroid treatment in septic shock.

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OBJECTIVE To evaluate the concept of relative adrenal insufficiency necessitating corticosteroid therapy in septic shock. METHODS Retrospective study. METHODS Medical-surgical intensive care unit of a university hospital. METHODS We studied 218 consecutive patients with septic shock in a 3-yr period

Adrenal insufficiency in the critically III trauma population.

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Acute adrenal insufficiency has been demonstrated in a number of patients with shock. This study was designed to evaluate the rate of occult adrenal insufficiency in the critically ill trauma population and to determine the impact of hypoproteinemia on the use of random cortisol levels as a marker

A case of factitious adrenal insufficiency after vascular graft surgery caused by spurious immunometric assays.

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A 70-year-old man with abdominal aortic aneurysm underwent surgical repair with Hemashield vascular graft. Postoperatively, he was found to have very low plasma cortisol levels, which failed to increase after stimulation with ACTH. A tentative diagnosis of adrenal insufficiency was made despite the

Clinical analysis of patients of cirrhosis complicated with adrenal insufficiency.

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To evaluate the level of cortisol and adrenocorticotrophic hormone (ACTH) in patients with cirrhosis and to investigate the clinical significance and characteristics of cirrhosis with adrenal insufficiency (AI). A total of 118 patients that were hospitalized in the Department of Gastroenterology of

Characterization of Cortisol Secretion Rate in Secondary Adrenal Insufficiency.

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UNASSIGNED In secondary adrenal insufficiency (SAI), chronic deficiency of adrenocorticotropin (ACTH) is believed to result in secondary changes in adrenocortical function, causing an altered dose-response relationship between ACTH concentration and cortisol secretion rate (CSR). UNASSIGNED We

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