How much is enough? Evaluation of adrenal function in children who undergo growth hormone stimulation test.

The objective was to determine the probability of receiving steroid treatment following an insulin tolerance test (ITT) for short-stature evaluation and to evaluate the utility of a subsequent cortrosyn stimulation test (CST) in determining adrenal sufficiency. We retrospectively analyzed the hypothalamic-pituitary-adrenal (HPA) axis evaluation in short-stature subjects during the 5-year period from January 2005 to December 2009. The probability of receiving steroid treatment was < 10% when the maximum cortisol concentration during an ITT was < 8.4 microg/dL. In the event of a suboptimal cortisol response during an ITT, only a single 1-microg CST is recommended for assessment of adrenal function.