What is the role of serum cortisol testing in the workup of pediatric adrenal insufficiency (Addison disease)?

Updated: Mar 10, 2020
  • Author: Kimberly Tafuri, DO; Chief Editor: Sasigarn A Bowden, MD  more...
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Interpret random serum cortisol concentrations in the context in which they were obtained. For example, adrenal insufficiency (Addison disease) is unlikely in an otherwise healthy individual whose 8:00 am serum cortisol concentration is more than 10 mcg/dL. By contrast, a serum cortisol concentration less than 18 mcg/dL in a sick and stressed patient is suggestive of adrenal insufficiency, although some critically ill patients may have such cortisol concentrations due to lack of protein binding to cortisol (see Relative adrenal insufficiency under Etiology).

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