LABORATORY TESTS FOR ADRENAL FUNCTION

• · Tests of pituitary adrenal responsiveness.
• · Suppression tests -are measurement of target hormone response after suppression of its tropic hormone.
• · Stimulation tests
• · Plasma ‘Levels of ACTH and angiotensin II.
• · Measurement of urinary free cortisol
• · Measurement of urinary creatinine
• · Measurement of plasma and urinary level of ste­roids.
• · Measurement of peripheral plasma renin activ­ity (PRA)
• · Measurement of DHEA (Dehydroepiandrosterone)
• · Measurement of cortisol and aldosterone.
• – Tests of pituitary adrenal suppressibility
• – Tests of mineralocorticoid suppressibility
• – Test of mineralocorticoid reserve
• – Test of glucocorticoid reserve- Rapid ACTH stimulation test
• Seeking a treatable cause of the primary disorder (eg, histoplasmosis involving the adrenal glands or a pituitary adenoma compromising normal pituitary function)
• evaluating mineralocorticoid secretion in patients without ACTH deficiency
• Determining whether the cortisol deficiency is dependent on or independent of ACTH deficiency
• Demonstrating inappropriately low cortisol secretion

HYPERFUNCTION OF ADRENAL CORTEX

• Excess of cortisol causes Cushing’s syndrome. Excess of aldosterone causes Aldosteronism.
• Excess of adrenal androgen causes Virilism (male fea­tures in females).

Diagnostic approach to suspected adrenal insufficiency