Contents:
Medical Video: Understanding the Short Synacthen Test
Definition
What is acth stimulation with metyrapone?
Metyrapone is a drug that prevents cortisol formation. Cortisol is a hormone produced by adrenocorticotropic. When consumed, the drug will reduce cortisol production so that it stimulates the pituitary gland.
This test is used to check if there is ACTH secretion by the tumor. In addition, this test is also used to diagnose Cushing's syndrome or adrenal insufficiency.
This type of test is similar to the Cosyntropin test.
When should I undergo acth stimulation with metyrapone?
This test is done in several cases such as the following:
- distinguish adrenal hyperplasia from primary adrenal tumors
- detect Cushing's syndrome
- detect adrenal insufficiency
- detect the performance of the pituitary gland
Prevention & warning
What should I know before undergoing acth stimulation with metyrapone?
This test is recommended for patients who:
- the possibility of having adrenal insufficiency
- use glucocorticosteroid
Complications that can occur during the test include:
- Addison's disease and adrenal insufficiency get worse because metyrapone inhibits cortisol production
- dizziness, drowsiness, allergic reactions to drugs and bone marrow suppression
Factors that influence test results include:
- radioisotope
- chlorpromazine which can block the response to metyrapone so it should not be used during the test
Pay attention to warnings and precautions before undergoing this treatment. If you have questions, please consult a doctor for further information and instructions.
Process
What should I do before undergoing acth stimulation with metyrapone?
There is no special preparation before undergoing this test. However, your doctor may check your health condition first. Consult your doctor about certain preparations before undergoing the test. You are recommended to use short-sleeved clothing to make it easier to take blood samples from your hands.
What is the process of acth stimulation with metyrapone?
On a blood test, you will be given metyrapone at 11 o'clock the night before the test is done. The next day, the medical expert will take blood from the vein into the tube.
In the urine test, the medical officer will collect your urine sample within 24 hours before the test to determine the 17-OCHS level as the initial benchmark. Then urine samples are collected to measure the level of 17-OCHS within 1 day after you consume metyrapone. Metyrapone medication is taken 5 times a day (24 hours) with an interval of 4 hours.
Medicines taken must be accompanied by milk to reduce the effects on the gastrointestinal tract.
What should I do after undergoing acth stimulation with metyrapone?
Some people may feel pain when a syringe is inserted into the skin. But for most people, the pain will gradually disappear when the needle is right in the vein. Generally, the level of pain experienced depends on the expertise of the nurse, the condition of the arteries, and a person's sensitivity to pain.
After going through the process of taking blood, wrap your hands in a bandage. Press the vein slowly to stop bleeding. After doing the test, you can do activities as usual.
Especially for urine tests, urine samples to be used must be given to the laboratory on time.
An emergency case occurs when complications arise and worsen adrenal insufficiency. Handling of medical personnel in this case includes administration of cortisol, shock-resistance, and restoration of blood flow.
If you have questions about the test process, please consult a doctor for further instructions.
Explanation of Test Results
What do the test results mean?
Normal
- blood: 11-deoxycortisol levels increased> 7 mcg / dL and cortisol <10 mcg / dL
- urine (24 hours): basic excretion of 17-hydroxycorticosteroids (17-Ochs) doubled
Abnormal
- an increase in cortisol precursors indicates that you experience adrenal hyperplasia
- no changes to cortisol precursors indicate disease:
- adrenal tumor
- ectopic ACTH syndrome
- secondary adrenal insufficiency.
The normal range for adrenocorticotropic hormone (ACTH) stimulation tests with Metyrapone can vary depending on the laboratory you choose. Please discuss with your doctor if there are questions about your test results.
Hello Health Group does not provide medical advice, diagnosis or treatment.
