Arguably, with increased testing, the prevalence of adrenal incidentalomas and drug-induced adrenal insufficiency has been increasing. Laugesen and colleagues compared the Elecsys Cortisol II immunoassay (ElecsysCort II) with liquid chromatography–tandem mass spectrometry during dynamic testing, and evaluated the diagnostic performance of baseline cortisol cutoffs (0-min cortisol during a short Synacthen test). 

The study included 547 overnight dexamethasone suppression tests (44% abnormal), mainly performed in patients with adrenal incidentaloma (69%), and 519 Synacthen tests (32% abnormal).

The findings support the use of ElecsysCort II in general and baseline cortisol as a screening tool for adrenal insufficiency. The authors suggest that the high proportion of abnormal overnight dexamethasone suppression tests among patients with incidentaloma warrants further study.

Read the full article in Endocrine Connections https://doi.org/10.1530/EC-25-0600