A Simplified Metyrapone Test with Determination of Plasma 11-Deoxycortisol (Metyrapone Test with Plasma S)

Meikle, A.W.; Jubiz, William; Hutchings, Mary P.; West, Charles D.; Tyler, Frank H.

doi:10.1210/jcem-29-7-985

Cited by 42 publications

(6 citation statements)

References 4 publications

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“…Following decapitation, 100 ^il aliquots of serum were collected from trunk blood and then were extracted with 1 vol hexane to remove progesterone (21). Corticosteroids were extracted next with 10 vol of dichloromethane.…”

Section: Methodsmentioning

confidence: 99%

Serotonergic Changes in Specific Areas of Rat Brain Associated with Activity-Stress Gastric Lesions

Hellhammer

Hingtgen²,

Wade³

et al. 1983

Psychosomatic Medicine

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To study serotonergic involvement in the development of gastric lesions following activity wheel stress, three groups of rats (gastric lesions, no gastric lesions, and home--cage controls) were killed following exposure to the experimental procedures. The brains were dissected into eight specific areas and subjected to analyses for serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) using high performance liquid chromatography with EC detection. Lower levels of 5-HT were found in the midbrain, cortex, and hippocampus of rats with gastric lesions compared to either the no lesion group, subjected to shorter periods of activity--stress, or the home--cage control group. Levels of 5-HT and 5-HIAA were elevated in the pons/medulla oblongata of both the lesion and the no lesion groups compared to the home--cage controls. Corticosterone levels in blood were also significantly elevated in the lesion group. These data on serotonin changes in the CNS suggest a possible role for this neurotransmitter in stress-induced gastric pathology.

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Section: Methodsmentioning

confidence: 99%

Serotonergic Changes in Specific Areas of Rat Brain Associated with Activity-Stress Gastric Lesions

Hellhammer

Hingtgen²,

Wade³

et al. 1983

Psychosomatic Medicine

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“…Plasma cortisol was measured by the method of Beitins et al (10), 11-deoxycortisol (compound S) was measured by the method of Meikle et al (11), and TSH was measured by RIA (12). Urinary (22).…”

Section: Methodsmentioning

confidence: 99%

ACTH-Secreting Medullary Carcinoma of the Thyroid Presenting as Severe Idiopathic Osteoporosis and Senile Purpura: Report of a Case and Review of the Literature*

Rosenberg

Hahn

Orth

et al. 1978

The Journal of Clinical Endocrinology & Metabolism

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A 64-yr-old female presented with severe osteoporosis and easy bruisability of over 2-yr duration. Biopsy of a neck mass revealed medullary carcinoma of the thyroid. Subsequently, lymphangitic pulmonary metastases were demonstrated which had been present radiographically for at least 4 yr. Basal serum calcitonin was markedly elevated and increased during calcium infusion. The diagnosis of ectopic ACTH syndrome was first entertained when hypokalemic alkalosis was observed during evaluation of her carcinoma. Elevated urinary 17-hydroxycorticosteroids, 17-ketosteroids, plasma cortisol, and immunoreactive plasma ACTH levels were documented. Adrenal steroidogenesis seemed to suppress on high dose dexamethasone. The primary tumor and its metastases contained high concentrations of immunoreactive ACTH and beta-melanocyte-stimulating hormone. Hepatic metastases contained extremely high concentrations of calcitonin. In contrast to the usual presentation of the ectopic ACTH syndrome as primarily hypokalemic alkalosis and glucose intolerance, patients with relatively benign and indolent ACTH-secreting tumors, such as certain cases of medullary carcinoma of the thyroid, may present with more typical signs and symptoms of Cushing's syndrome. The more pronounced cushingoid features in this latter group presumably reflects a more prolonged period of exposure to elevated glucocorticoid levels. Ten cases of ACTH-secreting medullary carcinoma of the thyroid from the literature are discussed. Extopic ACTH production by such tumors should be considered in the evaluation of patients with Cushing's syndrome or unexplained severe osteopenia.

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“…However, these tests had the disadvantages of complicated drug regimens and timed urine collections. In an effort to avoid these disadvantages, abbreviated, overnight versions of both the dexamethasone and metyrapone tests were introduced in order to shorten their duration, simplify the drug regimen, and rely on plasma rather than urine measurements (Meikle et al, 1969;Sparks et al, 1969;Spiger et al, 1975;Tucci, 1975;Nishida et al, 1984;Tyrrell et al, 1986;Snow et al, 1992;Dichek et al, 1994).…”

mentioning

confidence: 99%

“…Experience with the overnight metyrapone test is limited. Most of the existing literature addresses its use for differentiating pituitary from adrenal (Meikle et al, 1969;Sparks et al, 1969;Spiger et al, 1975;Tucci, 1975) rather than from ectopic ACTH-producing causes of Cushing's syndrome (Snow et al, 1992). Additionally, none of the previous studies have determined criteria for the diagnosis of Cushing's disease which have 100% specificity in excluding patients with ectopic ACTH syndrome.…”

mentioning

confidence: 99%

A comparison of the overnight and the standard metyrapone test for the differential diagnosis of adrenocorticotrophin‐dependent Cushing’s syndrome

Avgerinos

Nieman

Oldfield

et al. 1996

Clinical Endocrinology

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The single-dose overnight metyrapone test, which can be performed in 24 hours and which avoids the disadvantages associated with timed urine collections, has a nearly identical sensitivity (for a specificity of 100%) as the 6-dose standard metyrapone test for the diagnosis of Cushing's disease. Furthermore, the diagnostic performance of a criterion that combines the results of both tests is significantly better than the best criterion for either test alone.

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A Simplified Metyrapone Test with Determination of Plasma 11-Deoxycortisol (Metyrapone Test with Plasma S)

Cited by 42 publications

References 4 publications

Serotonergic Changes in Specific Areas of Rat Brain Associated with Activity-Stress Gastric Lesions

Serotonergic Changes in Specific Areas of Rat Brain Associated with Activity-Stress Gastric Lesions

ACTH-Secreting Medullary Carcinoma of the Thyroid Presenting as Severe Idiopathic Osteoporosis and Senile Purpura: Report of a Case and Review of the Literature*

A comparison of the overnight and the standard metyrapone test for the differential diagnosis of adrenocorticotrophin‐dependent Cushing’s syndrome

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