Normal Cortisol Response on Low-Dose Synacthen (1 μg) Test in Children with Prader Willi Syndrome
Introduction: It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children wit...
Saved in:
Published in | The journal of clinical endocrinology and metabolism Vol. 95; no. 12; pp. E464 - E467 |
---|---|
Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Endocrine Society
01.12.2010
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Introduction: It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children with PWS. We used a low-dose Synacthen test to screen for CAI in children with PWS.
Methods: We studied 41 children with genetic diagnosis of PWS [20 males; mean age, 7.68 (±5.23) yr] in five pediatric endocrinology centers in Australasia. All participants were randomly selected, and none had a history of Addisonian crisis. Ten of the cohort were receiving sex hormone therapy, 19 were receiving GH, and four were receiving T4. Their mean body mass index z-score was +1.48 (±1.68). Baseline morning ACTH and cortisol levels were measured, followed by iv administration of 1 μg Synacthen. Post-Synacthen cortisol levels were measured at 30 min, and a cortisol level above 500 nmol/liter was considered normal.
Results: The mean baseline ACTH and cortisol were 15 (±14) ng/liter and 223 (±116) nmol/liter, respectively. The mean 30-min plasma cortisol was 690 (±114) nmol/liter, and the average increase from baseline was 201%.
Conclusions: Our result suggests that CAI is rare in children with PWS.
Prevalence of central adrenal insufficiency in children with Prader Willi syndrome is rare. |
---|---|
AbstractList | Introduction: It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children with PWS. We used a low-dose Synacthen test to screen for CAI in children with PWS.
Methods: We studied 41 children with genetic diagnosis of PWS [20 males; mean age, 7.68 (±5.23) yr] in five pediatric endocrinology centers in Australasia. All participants were randomly selected, and none had a history of Addisonian crisis. Ten of the cohort were receiving sex hormone therapy, 19 were receiving GH, and four were receiving T4. Their mean body mass index z-score was +1.48 (±1.68). Baseline morning ACTH and cortisol levels were measured, followed by iv administration of 1 μg Synacthen. Post-Synacthen cortisol levels were measured at 30 min, and a cortisol level above 500 nmol/liter was considered normal.
Results: The mean baseline ACTH and cortisol were 15 (±14) ng/liter and 223 (±116) nmol/liter, respectively. The mean 30-min plasma cortisol was 690 (±114) nmol/liter, and the average increase from baseline was 201%.
Conclusions: Our result suggests that CAI is rare in children with PWS.
Prevalence of central adrenal insufficiency in children with Prader Willi syndrome is rare. It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children with PWS. We used a low-dose Synacthen test to screen for CAI in children with PWS. We studied 41 children with genetic diagnosis of PWS [20 males; mean age, 7.68 (±5.23) yr] in five pediatric endocrinology centers in Australasia. All participants were randomly selected, and none had a history of Addisonian crisis. Ten of the cohort were receiving sex hormone therapy, 19 were receiving GH, and four were receiving T4. Their mean body mass index z-score was +1.48 (±1.68). Baseline morning ACTH and cortisol levels were measured, followed by iv administration of 1 μg Synacthen. Post-Synacthen cortisol levels were measured at 30 min, and a cortisol level above 500 nmol/liter was considered normal. The mean baseline ACTH and cortisol were 15 (±14) ng/liter and 223 (±116) nmol/liter, respectively. The mean 30-min plasma cortisol was 690 (±114) nmol/liter, and the average increase from baseline was 201%. Our result suggests that CAI is rare in children with PWS. INTRODUCTIONIt has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children with PWS. We used a low-dose Synacthen test to screen for CAI in children with PWS.METHODSWe studied 41 children with genetic diagnosis of PWS [20 males; mean age, 7.68 (±5.23) yr] in five pediatric endocrinology centers in Australasia. All participants were randomly selected, and none had a history of Addisonian crisis. Ten of the cohort were receiving sex hormone therapy, 19 were receiving GH, and four were receiving T4. Their mean body mass index z-score was +1.48 (±1.68). Baseline morning ACTH and cortisol levels were measured, followed by iv administration of 1 μg Synacthen. Post-Synacthen cortisol levels were measured at 30 min, and a cortisol level above 500 nmol/liter was considered normal.RESULTSThe mean baseline ACTH and cortisol were 15 (±14) ng/liter and 223 (±116) nmol/liter, respectively. The mean 30-min plasma cortisol was 690 (±114) nmol/liter, and the average increase from baseline was 201%.CONCLUSIONSOur result suggests that CAI is rare in children with PWS. Introduction: It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death rates in Prader Willi syndrome (PWS). A study using the overnight metyrapone test reported a 60% prevalence of CAI in children with PWS. We used a low-dose Synacthen test to screen for CAI in children with PWS. Methods: We studied 41 children with genetic diagnosis of PWS [20 males; mean age, 7.68 (±5.23) yr] in five pediatric endocrinology centers in Australasia. All participants were randomly selected, and none had a history of Addisonian crisis. Ten of the cohort were receiving sex hormone therapy, 19 were receiving GH, and four were receiving T4. Their mean body mass index z-score was +1.48 (±1.68). Baseline morning ACTH and cortisol levels were measured, followed by iv administration of 1 μg Synacthen. Post-Synacthen cortisol levels were measured at 30 min, and a cortisol level above 500 nmol/liter was considered normal. Results: The mean baseline ACTH and cortisol were 15 (±14) ng/liter and 223 (±116) nmol/liter, respectively. The mean 30-min plasma cortisol was 690 (±114) nmol/liter, and the average increase from baseline was 201%. Conclusions: Our result suggests that CAI is rare in children with PWS. |
Author | Ambler, Geoffrey R Archbold, Sinead M Hofman, Paul Harris, Mark Cotterill, Andrew M Crock, Patricia A Nyunt, Ohn Verge, Charles F Wu, Joyce Y Leong, Gary M |
Author_xml | – sequence: 1 givenname: Ohn surname: Nyunt fullname: Nyunt, Ohn – sequence: 2 givenname: Andrew M surname: Cotterill fullname: Cotterill, Andrew M – sequence: 3 givenname: Sinead M surname: Archbold fullname: Archbold, Sinead M – sequence: 4 givenname: Joyce Y surname: Wu fullname: Wu, Joyce Y – sequence: 5 givenname: Gary M surname: Leong fullname: Leong, Gary M – sequence: 6 givenname: Charles F surname: Verge fullname: Verge, Charles F – sequence: 7 givenname: Patricia A surname: Crock fullname: Crock, Patricia A – sequence: 8 givenname: Geoffrey R surname: Ambler fullname: Ambler, Geoffrey R – sequence: 9 givenname: Paul surname: Hofman fullname: Hofman, Paul – sequence: 10 givenname: Mark surname: Harris fullname: Harris, Mark |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20810574$$D View this record in MEDLINE/PubMed |
BookMark | eNptkM9uEzEQhy1URNPCjTPyra3Elhn_ya6PVaCAFFFEW8HN8trextGundobVX23PgPPxEYpnDjNSPPNTzPfETmIKXpC3iKcI0P4sLbnDBAqmIv6BZmhErKqUdUHZAbAsFI1-3VIjkpZA6AQkr8ihwwaBFmLGWm_pTyYni5SHkNJPf3hyybF4mmKdJkeqo9p6q8fo7Hjykd6ivT3090ZvfFlpCHSxSr0Lk-DhzCu6PdsnM_0Z-j7sFtyOQ3-NXnZmb74N8_1mNxefrpZfKmWV5-_Li6WleU1GysHzAgpUDRocc4ECGSiYzA3XAlmpay7RrmatabtOuCtctwpKY2SKMCg4sfkZJ-7yel-O92nh1Cs73sTfdoW3eCcN5IxPpHv96TNqZTsO73JYTD5USPonVS9tnonVe-kTvi75-BtO3j3D_5rcQL4HvDRJZtD9JvsS9HrtM1xevn_sX8AyTqDlA |
CitedBy_id | crossref_primary_10_1210_en_2010_0709 crossref_primary_10_14341_omet201439_17 crossref_primary_10_1002_ajmg_a_38713 crossref_primary_10_1186_s13023_015_0312_z crossref_primary_10_1515_jpem_2017_0487 crossref_primary_10_3390_ijms241713109 crossref_primary_10_1186_s12902_020_00646_w crossref_primary_10_3389_fendo_2024_1406931 crossref_primary_10_1210_clinem_dgaa168 crossref_primary_10_1002_ajmg_a_35653 crossref_primary_10_1155_2012_473941 crossref_primary_10_1515_jpem_2022_0468 crossref_primary_10_1530_EC_22_0373 crossref_primary_10_3390_diseases4010005 crossref_primary_10_3389_fendo_2022_1021704 crossref_primary_10_1515_jpem_2022_0074 crossref_primary_10_3389_fendo_2024_1382583 crossref_primary_10_1007_s40618_015_0312_9 crossref_primary_10_1111_j_1365_2265_2011_04313_x crossref_primary_10_1007_s11154_019_09502_2 crossref_primary_10_1210_jc_2012_3888 crossref_primary_10_1155_2011_784867 crossref_primary_10_1111_jpc_12294 crossref_primary_10_1586_17446651_2013_853449 crossref_primary_10_1186_s13148_021_01143_0 crossref_primary_10_1111_j_1365_2265_2012_04474_x crossref_primary_10_1186_1687_9856_2011_12 crossref_primary_10_1186_1687_9856_2013_14 crossref_primary_10_3389_fendo_2023_1146680 crossref_primary_10_1097_MED_0b013e32834fd881 crossref_primary_10_1111_cen_12150 |
Cites_doi | 10.1002/ajmg.a.20370 10.1017/S1462399405009531 10.1002/ajmg.a.32131 10.1111/j.1365-2265.2006.02570.x 10.1210/jcem.83.1.4496 10.1038/342281a0 10.1093/hmg/ddi456 10.1038/oby.2006.118 10.1111/j.1365-2265.1981.tb00362.x 10.1210/jc.2008-0710 10.1038/ng2114 10.1210/jc.2007-2294 10.1007/s10803-008-0546-x 10.1136/jnnp.2004.039024 10.1038/sj.ijo.0803128 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1210/jc.2010-0647 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE MEDLINE - Academic CrossRef |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1945-7197 |
EndPage | E467 |
ExternalDocumentID | 10_1210_jc_2010_0647 20810574 |
Genre | Research Support, Non-U.S. Gov't Multicenter Study Journal Article |
GeographicLocations | Australasia |
GeographicLocations_xml | – name: Australasia |
GroupedDBID | - 02 08R 0R 1TH 29K 2WC 34G 39C 3O- 3V. 4.4 48X 53G 55 5GY 5RS 5YH 7X7 88E 8F7 8FI 8FJ AABJS AABMN AAIMJ AAJQQ AAPQZ AAQQT AAUQX AAWTL AAYJJ ABFLS ABOCM ABPMR ABPPZ ABSAR ABUWG ACGFS ACIMA ACPRK ACUTJ ADBBV ADBIT ADEIU ADGZP ADHKW ADRTK AELNO AELWJ AEMDU AENEX AENZO AETBJ AEWNT AFCHL AFFNX AFKRA AFRAH AFXEN AGINJ AGKRT AGVJH AHMBA AIKOY AIMBJ ALMA_UNASSIGNED_HOLDINGS APIBT AQKUS ARIXL ASMCH ASPBG AVWKF AYOIW AZFZN AZQFJ BAWUL BAYMD BBAFP BCRHZ BENPR BEYMZ BGYMP BHONS BPHCQ BSWAC BTRTY BVXVI C45 CDBKE CS3 D-I DAKXR DIK DPPUQ E3Z EBS EIHJH EJD ENERS F5P FEDTE FH7 FHSFR FOTVD FQBLK FYUFA G8K GAUVT GJ GJXCC GX1 H1 H13 HVGLF HZ H~9 IAO IHR INH J5H KBUDW KOP KQ8 KSN L7B M1P M5 MBLQV MHKGH N9A NLBLG NOYVH NVLIB O0- O9- OBH OCB ODMLO OGEVE OK1 OVD P2P PQEST PQQKQ PQUKI PRINS PROAC PSQYO REU ROX ROZ TCN TJX TLC TMA TWZ VH1 WOQ X X52 X7M XZ ZA5 ZGI ZXP ZY1 --- -~X .55 .GJ .XZ 08P 0R~ 18M 354 AABZA AACZT AAKAS AAPGJ AAPXW AARHZ AAUAY AAVAP AAWDT ABBLC ABJNI ABLJU ABMNT ABNHQ ABPQP ABPTD ABQNK ABWST ABXVV ACFRR ACGFO ACYHN ACZBC ADGKP ADQBN ADVEK ADZCM AERZD AFFZL AFGWE AFOFC AFXAL AFYAG AGMDO AGQXC AGUTN AI. AJEEA APJGH AQDSO ATGXG AVNTJ CGR CUY CVF ECM EIF EMOBN FECEO FLUFQ FOEOM HZ~ ITC KSI M5~ MJL N4W NOMLY NPM OAUYM OFXIZ OHH OJZSN OPAEJ OVIDX P6G TEORI TR2 VVN W8F WHG YBU YFH YHG YOC YSK ~02 ~H1 AAYXX CITATION 7X8 |
ID | FETCH-LOGICAL-c372t-d02a4541481c162404124f206a3942c557f89d72babff03b9d3d955a95140a193 |
ISSN | 0021-972X |
IngestDate | Fri Aug 16 07:10:05 EDT 2024 Thu Sep 12 16:23:02 EDT 2024 Sat Sep 28 07:54:21 EDT 2024 Tue Jan 05 21:44:40 EST 2021 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 12 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c372t-d02a4541481c162404124f206a3942c557f89d72babff03b9d3d955a95140a193 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
OpenAccessLink | https://academic.oup.com/jcem/article-pdf/95/12/E464/9092665/jcemE464.pdf |
PMID | 20810574 |
PQID | 816385223 |
PQPubID | 23479 |
ParticipantIDs | proquest_miscellaneous_816385223 crossref_primary_10_1210_jc_2010_0647 pubmed_primary_20810574 endocrinepress_journals_10_1210_jc_2010_0647 |
PublicationCentury | 2000 |
PublicationDate | 2010-12-01 |
PublicationDateYYYYMMDD | 2010-12-01 |
PublicationDate_xml | – month: 12 year: 2010 text: 2010-12-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | The journal of clinical endocrinology and metabolism |
PublicationTitleAlternate | J Clin Endocrinol Metab |
PublicationYear | 2010 |
Publisher | Endocrine Society |
Publisher_xml | – name: Endocrine Society |
References | Dimitropoulos (2020071616561492100_R7) 2008; 38 Stevenson (2020071616561492100_R15) 2004; 124A Nicholls (2020071616561492100_R3) 1989; 342 Shapira (2020071616561492100_R10) 2005; 76 Kozlov (2020071616561492100_R20) 2007; 39 Bittel (2020071616561492100_R4) 2005; 7 Hinton (2020071616561492100_R9) 2006; 30 Kazlauskaite (2020071616561492100_R18) 2008; 93 Craig (2020071616561492100_R11) 2006; 65 Wijngaarden (2020071616561492100_R14) 2008; 93 Sonino (2020071616561492100_R19) 1981; 14 Tauber (2020071616561492100_R13) 2008; 146 Eiholzer (2020071616561492100_R2) 2005 Johnstone (2020071616561492100_R6) 2006; 15 Robinson (2020071616561492100_R5) 1991; 49 Eiholzer (2020071616561492100_R12) 2002; 58 Abdu (2020071616561492100_R16) 1999; 84 Prader (2020071616561492100_R1) 1956; 86 Holsen (2020071616561492100_R8) 2006; 14 Weintrob (2020071616561492100_R17) 1998; 83 |
References_xml | – volume: 124A start-page: 158 year: 2004 ident: 2020071616561492100_R15 article-title: Unexpected death and critical illness in Prader-Willi syndrome: report of ten individuals publication-title: Am J Med Genet Part A doi: 10.1002/ajmg.a.20370 contributor: fullname: Stevenson – volume: 58 start-page: 24 issue: Suppl 3 year: 2002 ident: 2020071616561492100_R12 article-title: Fatal outcome of sleep apnoea in PWS during the initial phase of growth hormone treatment publication-title: A case report. Horm Res contributor: fullname: Eiholzer – volume: 7 start-page: 1 year: 2005 ident: 2020071616561492100_R4 article-title: Prader-Willi syndrome: clinical genetics, cytogenetics and molecular biology. publication-title: Expert Rev Mol Med doi: 10.1017/S1462399405009531 contributor: fullname: Bittel – volume: 146 start-page: 881 year: 2008 ident: 2020071616561492100_R13 article-title: Review of 64 cases of death in children with Prader-Willi syndrome (PWS). publication-title: Am J Med Genet Part A doi: 10.1002/ajmg.a.32131 contributor: fullname: Tauber – volume: 65 start-page: 178 year: 2006 ident: 2020071616561492100_R11 article-title: Growth hormone treatment and adverse events in Prader-Willi syndrome: data from KIGS (the Pfizer International Growth Database). publication-title: Clin Endocrinol (Oxf) doi: 10.1111/j.1365-2265.2006.02570.x contributor: fullname: Craig – volume: 83 start-page: 88 year: 1998 ident: 2020071616561492100_R17 article-title: Standard and low-dose short adrenocorticotropin test compared with insulin-induced hypoglycemia for assessment of the hypothalamic-pituitary-adrenal axis in children with idiopathic multiple pituitary hormone deficiencies. publication-title: J Clin Endocrinol Metab doi: 10.1210/jcem.83.1.4496 contributor: fullname: Weintrob – volume: 342 start-page: 281 year: 1989 ident: 2020071616561492100_R3 article-title: Genetic imprinting suggested by maternal heterodisomy in nondeletion Prader-Willi syndrome. publication-title: Nature doi: 10.1038/342281a0 contributor: fullname: Nicholls – volume: 15 start-page: 393 year: 2006 ident: 2020071616561492100_R6 article-title: A human imprinting centre demonstrates conserved acquisition but diverged maintenance of imprinting in a mouse model for Angelman syndrome imprinting defects. publication-title: Hum Mol Genet doi: 10.1093/hmg/ddi456 contributor: fullname: Johnstone – volume: 14 start-page: 1028 year: 2006 ident: 2020071616561492100_R8 article-title: Neural mechanisms underlying hyperphagia in Prader-Willi syndrome. publication-title: Obesity (Silver Spring) doi: 10.1038/oby.2006.118 contributor: fullname: Holsen – volume: 14 start-page: 31 year: 1981 ident: 2020071616561492100_R19 article-title: Clinical response to metyrapone as indicated by measurement of mineralocorticoids and glucocorticoids in normal children. publication-title: Clin Endocrinol (Oxf) doi: 10.1111/j.1365-2265.1981.tb00362.x contributor: fullname: Sonino – volume: 93 start-page: 4245 year: 2008 ident: 2020071616561492100_R18 article-title: Corticotropin tests for hypothalamic-pituitary-adrenal insufficiency: a metaanalysis. publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2008-0710 contributor: fullname: Kazlauskaite – volume: 84 start-page: 838 year: 1999 ident: 2020071616561492100_R16 article-title: Comparison of the low dose short synacthen test (1 microg), the conventional dose short synacthen test (250 microg), and the insulin tolerance test for assessment of the hypothalamo-pituitary-adrenal axis in patients with pituitary disease. publication-title: J Clin Endocrinol Metab contributor: fullname: Abdu – volume: 39 start-page: 1266 year: 2007 ident: 2020071616561492100_R20 article-title: The imprinted gene Magel2 regulates normal circadian output. publication-title: Nat Genet doi: 10.1038/ng2114 contributor: fullname: Kozlov – volume: 49 start-page: 1219 year: 1991 ident: 2020071616561492100_R5 article-title: Molecular, cytogenetic, and clinical investigations of Prader-Willi syndrome patients. publication-title: Am J Hum Genet contributor: fullname: Robinson – volume: 93 start-page: 1649 year: 2008 ident: 2020071616561492100_R14 article-title: High prevalence of central adrenal insufficiency in patients with Prader-Willi syndrome. publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2007-2294 contributor: fullname: Wijngaarden – volume: 38 start-page: 1642 year: 2008 ident: 2020071616561492100_R7 article-title: Food-related neural circuitry in Prader-Willi syndrome: response to high- versus low-calorie foods. publication-title: J Autism Dev Disord doi: 10.1007/s10803-008-0546-x contributor: fullname: Dimitropoulos – volume: 76 start-page: 260 year: 2005 ident: 2020071616561492100_R10 article-title: Satiety dysfunction in Prader-Willi syndrome demonstrated by fMRI. publication-title: J Neurol Neurosurg Psychiatry doi: 10.1136/jnnp.2004.039024 contributor: fullname: Shapira – volume: 86 start-page: 1260 year: 1956 ident: 2020071616561492100_R1 article-title: Ein Syndrom von Adipositas, Kleinwuchs, Kryptorchismus und Oligophrenie nach Myatonieartigem Zustand im Neugeborenenalter publication-title: Schweiz Med Wschr contributor: fullname: Prader – year: 2005 ident: 2020071616561492100_R2 contributor: fullname: Eiholzer – volume: 30 start-page: 313 year: 2006 ident: 2020071616561492100_R9 article-title: Neural representations of hunger and satiety in Prader-Willi syndrome. publication-title: Int J Obes (Lond) doi: 10.1038/sj.ijo.0803128 contributor: fullname: Hinton |
SSID | ssj0014453 |
Score | 2.2088158 |
Snippet | Introduction: It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased... It has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased unexplained death... INTRODUCTIONIt has been postulated that central adrenal insufficiency (CAI), resulting from hypothalamic dysfunction, may contribute to the increased... |
SourceID | proquest crossref pubmed endocrinepress |
SourceType | Aggregation Database Index Database Publisher |
StartPage | E464 |
SubjectTerms | Adrenocorticotropic Hormone - blood Australasia Body Mass Index Child Child, Preschool Cosyntropin - therapeutic use Female Gonadal Steroid Hormones - therapeutic use Hormones - therapeutic use Humans Hydrocortisone - blood Male Prader-Willi Syndrome - blood Prader-Willi Syndrome - drug therapy Reference Values Thyroxine - therapeutic use |
Title | Normal Cortisol Response on Low-Dose Synacthen (1 μg) Test in Children with Prader Willi Syndrome |
URI | http://dx.doi.org/10.1210/jc.2010-0647 https://www.ncbi.nlm.nih.gov/pubmed/20810574 https://search.proquest.com/docview/816385223 |
Volume | 95 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1bb9MwFLbKkBAPIK6j3OQHKoEgU26Ok0cohQmx8bBOlKfIduJpEySIpZq6P8YLv4HfxDmxnWSskxgvVZu6Tevz5Vyc73wm5Bn4RF8xZDUmHAoUiPBeynTsaVZkWgsdqgC7kXd2k-39-MOCLUajnwPW0rKRW-p0bV_J_1gVjoFdsUv2EpbtvhQOwHOwLzyCheHxn2y8iwknFv-4pXKNKvkt4bXEOwAf6xPvLZLR91aVUKhx0GoyvZxMZ5M30wNcDZhDRGi7_oYN3ahghPoS7UIMfvicoAEiayA40fVWllVRgw-qelWnb2UDGPvqVApxzXllhQ4-9QzgaY0dRVZW2xAs-zXa4c7We5ARi6J_7_PSrP-vwDd9GS5fnKOCzOxPKx1LdeiskT3C293WIVQZ_5zFzOOBofQ6B2526XRADQfueBYbiXQb2uElXxs2oO7FsKG2DDcgMSKgfwlxY7kEA_MjleOwHIddIVdDnjHkkr5fdNwiKFKt_Kn9B7bjAtulhic5kwvdcFYyDOiLK54285nfIjdtyUJfG_zdJqOyukOu7VhSxl0iDQypgyF1MKR1RR0MaQdD-jygv38dvKAIP3pYUQc_ivCjBn60hR918LtH9t_N5tNtz27d4amIh41X-KGIcYf5NFBBAlkjbnKuQz8RURaHijGu06zgoRRSaz-SWREVMI0C8v3YF1BU3CcbVV2VDwgNRAwBW2c8khBwSi44DpWi8JksVMrGZOImMf9uFFrydaYak1dnZzi3l8rxBcOpm_8cPC7eRhNVWS-P8xRLGHBq0ZhsGrt05w0hwYYCKH54uXM9Itf7S-Mx2Wh-LMsnkOs28mmLqz-oRqem |
link.rule.ids | 315,786,790,27955,27956 |
linkProvider | Geneva Foundation for Medical Education and Research |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Normal+Cortisol+Response+on+Low-Dose+Synacthen+%281+%CE%BCg%29+Test+in+Children+with+Prader+Willi+Syndrome&rft.jtitle=The+journal+of+clinical+endocrinology+and+metabolism&rft.au=Nyunt%2C+Ohn&rft.au=Cotterill%2C+Andrew+M&rft.au=Archbold%2C+Sinead+M&rft.au=Wu%2C+Joyce+Y&rft.date=2010-12-01&rft.pub=Endocrine+Society&rft.issn=0021-972X&rft.eissn=1945-7197&rft.volume=95&rft.issue=12&rft.spage=E464&rft.epage=E467&rft_id=info:doi/10.1210%2Fjc.2010-0647&rft.externalDocID=10_1210_jc_2010_0647 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0021-972X&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0021-972X&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0021-972X&client=summon |