Secondary adrenal insufficiency screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Screening
Although screening for Addison disease in the traditional sense is not routinely done, there are laboratory tests that can be undertaken if a diagnosis for Addison is suspected. For example, these include:
• Blood testing; measuring blood levels of sodium, potassium, cortisol and ACTH. A blood test can also measure antibodies associated with the condition.
• ACTH stimulation test; this test involves measuring the level of cortisol in the blood before and after an injection of synthetic ACTH.
• Insulin-induced hypoglycemia test; occasionally, this test is performed if pituitary disease is a possible cause of adrenal insufficiency (secondary adrenal insufficiency).
• Imaging tests; a computerized tomography (CT) scan of the abdomen to check the size of the adrenal glands and look for other abnormalities that may give insight to the cause of the adrenal insufficiency. An MRI scan of the pituitary gland may also be indicated.
It is important to note that some papers have found that adolescents with diabetes type 1 who experience recurrent unexplained hypoglycemia should be screened for Addison’s disease. [13] [14]