Chanson P, Rieu M, Strauch G, Laudat M H
Clinique des maladies endocriniennes et métaboliques, Hôpital Cochin, Paris.
Ann Endocrinol (Paris). 1987;48(6):465-7.
A 71-year-old man presented with clinical and common biological features of secondary adrenal insufficiency. Basal ACTH level was in the normal range. As it has been previously reported in ACTH deficiency, cortisol response to ACTH-test was normal. A single-dose metyrapone test, performed to confirm the diagnosis of adrenal insufficiency, gave unexpectedly normal results. However 11-desoxycortisol (compound S) response to standard-metyrapone test was subnormal ascertaining the diagnosis of ACTH-deficiency. Thus normal responses to single-dose metyrapone test do not imperatively exclude secondary adrenal failure.
一名71岁男性表现出继发性肾上腺功能不全的临床和常见生物学特征。基础促肾上腺皮质激素（ACTH）水平在正常范围内。正如之前在ACTH缺乏症中所报道的那样，皮质醇对ACTH试验的反应正常。为确诊肾上腺功能不全而进行的单剂量甲吡酮试验结果出人意料地正常。然而，标准甲吡酮试验中11-脱氧皮质醇（化合物S）的反应低于正常水平，从而确诊为ACTH缺乏症。因此，单剂量甲吡酮试验的正常反应并不能绝对排除继发性肾上腺功能衰竭。
