Subnormal plasma 11-deoxycortisol (compound S) responses to metyrapone were found in patients with adrenal insufficiency or with Cushing syndrome caused by adrenal tumors and in those receiving long-term glucocorticoid or diphenylhydantoin sodium therapy. High normal or exaggerated responses were seen in women receiving oral contraceptives, patients with Cushing syndrome caused by adrenal hyperplasia, and those with untreated hypothyroidism. Diabetes mellitus, hypoglycemia, congestive failure, and obesity also were associated with exaggerated responses.
Subnormal plasma S responses were observed in 15 patients who responded normally to a repeat test or to the standard metyrapone test. The abnormal response resulted from insufficient metyrapone, administration at the wrong time, or delay in obtaining the blood sample.
The single-dose metyrapone test may be the procedure of choice in screening for adrenal insufficiency.
Spiger M, Jubiz W, Meikle AW, West CD, Tylor FH. Single-Dose Metyrapone TestReview of a Four-Year Experience. Arch Intern Med. 1975;135(5):698–700. doi:10.1001/archinte.1975.00330050072012
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: