Adrenal Insufficiency Diagnosis

Diagnostic Applications

The cosyntropin test is valuable in diagnosing adrenal insufficiency in patients with hypo-osmolar hyponatremia, as adrenal insufficiency can present similarly to SIADH 1
It's used to evaluate suspected hypophysitis (inflammation of the pituitary gland), particularly in patients receiving immune checkpoint inhibitor therapy 2
The test helps distinguish primary from secondary adrenal insufficiency by evaluating the relationship between ACTH and cortisol levels 1

In cases of suspected adrenal crisis, treatment should not be delayed for diagnostic testing 1
Don't rely solely on electrolyte abnormalities for diagnosis, as hyponatremia may be only marginally reduced and hyperkalemia is present in only about 50% of cases 1
When treating secondary adrenal insufficiency with concurrent hypothyroidism, always start corticosteroids several days before thyroid hormone to prevent precipitating adrenal crisis 1