The<unk>  (also called the cosyntropin<unk> , tetracosactide<unk>  or Synacthen<unk>  is a medical<unk>  usually ordered and interpreted by endocrinologists to assess the functioning of the adrenal glands stress response by measuring the adrenal response to adrenocorticotropic hormone <unk> .<unk>  is a hormone produced in the pituitary gland that stimulates the adrenal glands to release cortisol, dehydroepiandrosterone (DHEAS) and aldosterone.
During the<unk> , a small amount of synthetic<unk>  is injected, and the amount of cortisol, and sometimes aldosterone, the adrenals produce in response is measured.  This<unk>  may cause mild to moderate side effects in some individuals.
This<unk>  is used to diagnose or exclude primary and secondary adrenal insufficiency, Addison's disease and related conditions.  In addition to quantifying adrenal insufficiency, the<unk>  can distinguish whether the cause is adrenal (low cortisol and aldosterone production) or pituitary (low<unk>  production).  The<unk>  is recognized as the gold standard assay of adrenal insufficiency, although this<unk>  is primarily used to determine the presence of Addison's disease and pituitary impairment.  The<unk>  is extremely sensitive (97% at 95% specificity) to primary adrenal insufficiency, but less so to secondary adrenal insufficiency (57-61% at 95% specificity); while secondary adrenal insufficiency may thus be dismissed by some interpreters on the basis of the<unk> , additional<unk> ing may be called for if probability of secondary adrenal insufficiency is particularly high.
Adrenal insufficiency is a potentially life-threatening condition. Treatment should be initiated as soon as the diagnosis is confirmed, or sooner if the patient presents in apparent adrenal crisis.
ACTH stimulation test
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21-hydroxylase deficiency ultrasound
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21-hydroxylase deficiency screening
21-hydroxylase deficiency MRI
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Hypopituitarism CT