GEORGE P. CHROUSOS, M.D.; ABRAHAM MUNABI, M.D.; GORDON B. CUTLER JR., M.D.; D. LYNN LORIAUX, M.D., PH.D.
To the editor: Since our article on the diagnosis of late-onset 21-hydroxylase deficiency was published (1), we have been asked the best way to do the 30-minute adrenocorticotrophic hormone (ACTH) stimulation test (1). Most questions center around the intravenous ACTH infusion of 1.67 U over 30 minutes, which is low when compared to the usual dose of 25 U (0.25 mg) given as an intravenous bolus (2), and the mode of administration (continuous versus bolus). The dose of 1.67 U ACTH infused continuously over 30 minutes is a pharmacologic dose that causes maximal adrenal stimulation. Eik-Nes and associates (3) saw
CHROUSOS GP, MUNABI A, CUTLER GB, LORIAUX DL. Late-Onset 21-Hydroxylase Deficiency. Ann Intern Med. ;97:281–282. doi: 10.7326/0003-4819-97-2-281_2
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Published: Ann Intern Med. 1982;97(2):281-282.
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