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Evaluating the low-dose ACTH stimulation test (LDST) in neonates: Ideal times for cortisol measurement

Journal of Clinical Endocrinology and Metabolism Sep 12, 2020

LeDrew R, Bariciak E, Webster R, et al. - Since low-dose adrenocorticotropic hormone stimulation testing (LDST) can be used to diagnose central adrenal insufficiency, however, uncertainty remains regarding optimal times to draw serum cortisol levels, researchers sought to determine optimal times to draw serum cortisol levels for the LDST in neonates. A retrospective chart review of LDSTs conducted on neonates between January 1, 2009-September 30, 2017. Forty-nine patients were involved in this analysis. In comparison to older children's research, the authors observed that most neonatal LDST cortisol peaks occurred at the 60-minute sampling time with the addition of a 30-minute sample providing substantial gain. Whether a 15-minute sample offers some benefit is unclear, making a case for revising LDST protocols for neonates to sample cortisol later on.

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