A comparison of the insulin tolerance/glucagon test with the short ACTH stimulation test in the assessment of the hypothalamo‐pituitary‐adrenal axis in the early post‐operative period after hypophysectomy

Abstract

The 250 microgram short ACTH stimulation test produces discordant results from the ITT in a clinically significant proportion of affected patients when assessing the HPA axis, although the rate of discordance varies according to the criteria used for normality for both the tests. We suggest that the ITT should remain the preferred test for assessing ACTH secretory capacity compared with the standard 250 microgram short ACTH stimulation test, both in the preoperative and in the early post-trans-sphenoidal hypophysectomy period.