ESPE Abstracts (2022) 95 P1-416

ESPE2022 Poster Category 1 Adrenals and HPA Axis (52 abstracts)

The assessment of the usefulness of morning cortisol and DHEAS concentration levels in the diagnosis of central adrenal insufficiency in pediatric patients - preliminary results

Ewa Szczudlik , Małgorzata Wójcik , Anna Stępniewska , Dominika Januś & Jerzy B. Starzyk


Department of Pediatric and Adolsecent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland

The diagnosis of central adrenal insufficiency (CAI) is challenging. The most popular diagnostic tool in pediatric population remains low-dose (1 μg) cosyntropin (LDC) test. Nevertheless, there is still a need for the CAI markers that might be used on an outpatient setting as a first-line screening. In adult patients morning cortisol and dehydroepiandrosterone sulphate (DHEAS) has been postulated as a possible markers. The aim of the study was to evaluate the usefulness of basal morning serum cortisol and DHEAS assessment to diagnose CAI in the pediatric population. Material and methods: In 94 pediatric patients suspected to have CAI basal cortisol and DHEAS levels were assessed, and LDC and was performed. Results: On the basis of LDC test 9 patients were diagnosed with CAI (group 1, maximal cortisol level < 140 ng/mL), in 70 CAI was excluded (group 2, maximal cortisol level > 200 ng/mL), in the rest the test results indicated partial CAI. Basal morning cortisol level was significantly lower in group 1, than in group 2 (33.3 vs. 112.1 ng/ml, P=0.04) as well as DHEAS level (16.8 vs. 86.5 µg/ml, P=0.00007). Despite these differences, it was not possible to determine the value of the cut-off point for any of the parameters. Conclusion: In pediatric patients with CAI basal morning cortisol and DHEAS levels are significantly lower than in patients with normal adrenal function. Nevertheless, due to the impossibility of drawing a cut-off point, they cannot replace stimulation tests.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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