Adrenal Insufficiency – Test Selection

Adrenal insufficiency is a potentially lethal disorder, and it requires prompt recognition and therapy. The clinical manifestations of adrenal insufficiency are, however, nonspecific, and the diagnosis is often challenging. This session will discuss available tests for adrenal insufficiency, focusing on test selection in different circumstances. Different topics will be discussed including investigation of tertiary adrenal insufficiency and how patients with this condition are tested and managed depending on the results of tests. We will discuss the recently published European Society of Endocrinology/Endocrine Society Guidelines for the diagnosis of glucocorticoid induced adrenal insufficiency and review in detail the use of waking saliva cortisone and when necessary the ACTH stimulation test in these patients. We will talk about the approach used when a patient presents with an adrenal crisis in the Emergency Department and is newly diagnosed with primary adrenal insufficiency. We will also go into the investigation and monitoring of adrenal suppression post adrenalectomy in Cushing's syndrome and the use of tests for the diagnosis of secondary adrenal insufficiency.

Adrenal Insufficiency – Test Selection

Miguel Debono, MD, FRCP, PhD

The University of Sheffield, Sheffield, UK

Adrenal Insufficiency – Test Selection

Adina Turcu, MD, MS

University of Michigan