The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Simplified Assessment of Pituitary-Adrenal Reserve: Measurement of Serum 11-Deoxycortisol and Cortisol After Metyrapone

[+] Article, Author, and Disclosure Information

Supported in part by a grant from the Milton Fund, Boston, Mass.

▸Requests for reprints should be addressed to Richard F. Spark, M.D., Director, Steroid Research Laboratory, Beth Israel Hospital, 330 Brookline Ave., Boston, Mass. 02215

Boston, Massachusetts

Ann Intern Med. 1971;75(5):717-723. doi:10.7326/0003-4819-75-5-717
Text Size: A A A

The metyrapone test has been improved by specific measurement of plasma 11-deoxycortisol. This simplified method measures 11-deoxycortisol and cortisol in a sample of 0.1 ml of plasma after a standard dose of metyrapone. In normal patients, after metyrapone ingestion, plasma 11-deoxycortisol rises from a base line of 0.8 ± 0.8 µg/100 ml to 16.8 ± 4.4 µg/100 ml, and plasma cortisol falls from 13.5 ± 5.1 µg/100 ml to 3.3 ± 2.8 µg/100 ml. After metyrapone 11-deoxycortisol is reduced only in adrenocorticotrophin (ACTH) deficiency. Patients with hypopituitarism or chronic corticoid therapy and 9 of 12 acromegalics had subnormal levels. Patients with the "empty sella" syndrome or trophic hormone deficiency other than ACTH had normal levels. In primary hypothyroidism postmetyrapone 11-deoxycortisol is significantly greater than in normals. This difference is thought to be caused by delayed metabolic clearance of the steroid. Simultaneous measurement of serum cortisol affords an internal standard for the degree of 11-hydroxylation block achieved by the amount of administered metyrapone.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.