TY - T1的诊断肾上腺机能不全ing ACTH stimulation test JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02149-2020 VL - 56 IS - 2 SP - 2002149 AU - Nanzer, Alexandra M. AU - D'Ancona, Grainne AU - Kelly, Philip A. AU - Jackson, David J. Y1 - 2020/08/01 UR - //www.qdcxjkg.com/content/56/2/2002149.abstract N2 - We acknowledge B. Lipworth's work and significant contribution in highlighting the metabolic consequences of steroid therapy in airways disease over the past decades. In their letter he and colleagues refer to a post-synthetic adrenocorticotropic hormone (ACTH, Synacthen) cortisol level of 500 nmol·L−1 as the accepted cut-off to diagnose impaired adrenal function. These diagnostic values were derived using older cortisol assays; however, the cortisol levels in our report relate specifically to the newer Roche Elecsys II Cortisol assay used at our centre that gives, on average, 25% lower serum cortisol values, with a cut-off of ≥420 nmol·L−1 for the 250 µg intramuscular short Synacthen test (SST) at 30 or 60 min [1]. The median cortisol level after SST was 490 nmol·L−1 (interquartile range (IQR) 453–620 nmol·L−1) in patients who passed the SST; in those who failed the SST the cortisol level after SST was 262 nmol·L−1 (IQR 130–310 nmol·L−1).When to wean? Steroid stewardship in the biologic era https://bit.ly/3cOL94R ER -