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Morning salivary cortisol versus short Synacthen test as a test of adrenal suppression
Rajan S Patel1, Steve R Shaw, Halena E McIntyre
1Department of Otolaryngology, North Glasgow Hospitals University, NHS Trust, Glasgow, UK. dr_rajan_patel@hotmail.com
Background:
The short Synacthen test (SST) is the most commonly used test for the assessment of adrenal suppression. We investigated the potential of a simpler and more cost-effective procedure [morning salivary cortisol (MSC)] as an outpatient screening tool to detect adrenal suppression in patients using topical intranasal corticosteroids for rhinosinusitis.
Method:
Forty-eight patients who were using topical corticosteroids underwent adrenal function assessment by way of SST and MSC measurement.
Results:
Sixteen of the 48 patients had impaired MSCs. Of these 16 patients, 15 had an impaired SST (sensitivity 100%) and one had a normal SST. All patients with normal MSCs also had normal SSTs (specificity 97%).
Conclusion:
The morning salivary cortisol measurement is a useful screening tool for adrenal suppression in this setting.
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