ACTH stimulation test (ACTH stimulation test)

Article written by doctor Biochemistry Test - Laboratory Department - Vinmec Ha Long International Hospital

ACTH stimulation test is to put into the body a quantity of artificial ACTH (synthetic ACTH for clinical use) to evaluate the response of the adrenal glands to ACTH, on that basis to assess the underlying cause. from the adrenal glands or due to a deficiency of adrenal stimulating hormone. ACTH stimulation test. It is also the gold standard in identifying difficult-to-diagnose adrenal hyperplasia.

nghiem-phap-kich-thich-acth-acth-stimulation-test-1 — Nghiệm pháp kích thích ACTH

1. What is ACTH?

ACTH (Adreno Corticotropin-Hormone), also known as adrenocorticotropic hormone, is an anterior pituitary hormone. Human ACTH is a 39-amino acid polypeptide chain, in which the first peptide consists of 24 amino acids that are the same in many animals and humans, the remaining peptide has no biological effect and is also different in each animal species. Synthetic ACTH for clinical use consists of only 24 amino acids. ACTH stimulates adrenocortical cells to secrete sugar metabolism hormones (cortcosteron, cortisol), stimulates melanin production (because ACTH has a similar structure to MSH, this may explain the cause of skin darkening in Addison's disease). ).

2. How is the ACTH stimulation test done?

2.1 The test will be performed as follows. Take 01 venous blood sample. amount of ACTH injected) 2.2 Tests performed during the assay ACTH quantification: usually performed prior to the assay. With blood samples taken in the test: Quantifying Cortisol, Aldosteron, 17OH-progesterone (Depending on each diagnostic purpose). Along with blood tests, quantification of urinary cortisol and 17-ketosteroids may also be performed (24-hour urine sample).

3. How should the patient prepare to perform the ACTH stimulation test?

It is necessary to limit exercise and eat foods high in carbohydrates (flour group, sugar) for about 12 to 24 hours before performing the test. You may need to fast for 6 hours before the test. Temporarily stop taking medications (eg, hydrocortisone) that may affect blood cortisol tests. Should know some information: When taking blood for testing / when injecting, it may cause a little or a lot of pain. Some people feel flushed, anxious, or nauseous after receiving an ACTH injection. If testing is done with a 24-hour urine sample, it is necessary to collect a complete urine volume (because the test result will be the measured result per liter multiplied by the urine volume, and possibly the urine concentration). urine output will not be the same at all times).

nghiem-phap-kich-thich-acth-acth-stimulation-test-2 — Lấy máu tĩnh mạch trong nghiệm pháp kích thích ACTH

4. When is the ACTH Stimulation Test needed?

ACTH stimulation test helps assess whether the adrenal or pituitary gland is normal.
Testing is often done when there are signs of adrenal disease, such as Addison's disease due to adrenal insufficiency or pituitary hormone deficiency; Cushing's disease (due to excessive secretion of ACTH by the pituitary gland) or Cushing's syndrome (due to hyperadrenocorticism),...
The test is also used to evaluate the recovery of pituitary and adrenal glands after treatment.
Is the gold standard to assess the degree of congenital adrenal hyperplasia in difficult cases.

5. Evaluation of test results

Adrenal cortex function is normal if cortisol levels increase after ACTH injection. Adrenal insufficiency: cortisol levels do not increase after ACTH injection. In the diagnosis of congenital adrenal hyperplasia, baseline 17OH-progesterone levels (blood sample prior to ACTH injection) and at 60 minutes are used to assess disease severity. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.