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The ACTH test in the diagnosis of hirsutism
M F Lima1, M G Nunes, C E Bonduki
1Department of Gynecology-Escola Paulista de Medicina-Federal University of São, Brazil.
Insights
The adrenocorticotropic hormone (ACTH) test aids in diagnosing adrenal insufficiency and hyperplasia. It helps predict genotypes and phenotypes in hyperandrogenism, especially in non-classical congenital adrenal hyperplasia.
Area of Science:
- Endocrinology
- Biochemistry
Background:
- The ACTH test is a standard diagnostic tool for adrenal insufficiency and congenital adrenal hyperplasia (CAH).
- Hirsutism can be a manifestation of CAH, particularly non-classical or late-onset forms.
Purpose of the Study:
- To review the historical use of the ACTH test in diagnosing hirsutism.
- To highlight the main indications for the ACTH test in this context.
- To emphasize its role in predicting genotype and phenotype in hyperandrogenic patients.
Main Methods:
- Review of historical data and clinical guidelines on ACTH testing.
- Analysis of diagnostic utility in patients with hirsutism and suspected adrenal enzymatic deficiencies.
Main Results:
- The ACTH test remains valuable for diagnosing adrenal insufficiency and various forms of CAH (3-HSD, 21-OH, 11-β-OH deficiencies).
- It is particularly useful for identifying non-classical or late-onset CAH presenting with hyperandrogenic manifestations like hirsutism.
Conclusions:
- Despite advances in molecular diagnostics, the ACTH test is crucial for predicting genetic and clinical outcomes in hirsutism related to CAH.
- The test aids physicians in managing patients with hyperandrogenism due to specific adrenal enzymatic defects.
Abstract:
The ACTH test has been used to confirm the diagnosis of adrenal insufficiency and the classic and the non-classic adrenal hyperplasia due to the 3-HSD, 21 OH e 110H deficiencies. This article reviews the historical aspects of the use of ACTH in the diagnosis of hirsutism and points out its mains indications. In spite of new biological molecular advances in the diagnosis of adrenal enzymatic deficiencies, the use of the ACTH test can help the physician to predict both genothipus and fenothipus in populations with hyperandrogenic manifestations due to non-classical or late-onset congenital adrenal hyperplasia.