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May 1975

Single-Dose Metyrapone TestReview of a Four-Year Experience

Author Affiliations

From the Veterans Administration Hospital (Drs. Jubiz and Meikle) and the Division of Metabolism, Department of Medicine, University of Utah College of Medicine (Drs. Spiger, Jubiz, Meikle, West, and Tyler), Salt Lake City.

Arch Intern Med. 1975;135(5):698-700. doi:10.1001/archinte.1975.00330050072012

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.