The Application of Serum Cortisol Level for Diagnosis and Guideline for Diagnosed Adrenal Insufficiency-การประยุกต์ใช้ระดับ Serum cortisol ในการวินิจฉัยและแนวทางการวินิจฉัย Adrenal insufficiency

Abstract

          Serum cortisol was used for diagnosis of adrenal insufficiency, assess the Hypothalamic- Pituitary-Adrenal axis (HPA axis) and diagnosis of Cushingีs syndrome.  The serum cortisol level can be done in a general hospital.  This retrospective descriptive analysis reviewed 62 patient records of medicine department of Chasoengsao hospital between October 1 and December 31, 2007.  In 62 patients, 20 men and 42 women, 8 patients had serum cortisol £ 5 ug/dl and 37 patients had serum cortisol ³ 18 ug/dl.  Within 24 hours before blood sampling 10 patients received hydrocortisone.  Of the 28 patients whose blood sample were drawn during severe stress, 20 patients had serum cortisol ³ 18 ug/dl and £ 5 ug/dl in only one patient.  Serum cortisol was checked between 6- 8 am in 28 patients and 18 patients was checked at any time.  This paper describes and recommends guideline for checking and interpret serum cortisol for diagnosis and treatment relevant to adrenal insufficiency.

Key words:      serum cortisol, adrenal insufficiency